Clinico-pathological Study on IgA Nephropathy Presenting with Nephrotic Syndrome

Objective:To study the clinical and pathological features of IgA nephropathy presenting with nephrotic syndrome and their relationships with prognogsis.Methods:Clinical,laboratory,pathological,immuo-historical and morphometric studies were performed in 72 biopsied patients with IgA nephropathy presenting with nephrotic syndrome and their associations with outcome were analyzed.Results:These patients had high incidence of hypertension,gross and microscopic hematuria,azotemia,anemia and various pathological manifestations.Complete remission,partial remission,persistent non-nephrotic range proteinuria,persistent nephrotic range protein and progress of chronic renal feilure were found in 22,15,16,8 and 10 patients respectively.patient outcomes were associated with clinical menifestations,laboratory findings and pathological features.Steroid-responsive patients had a lower incidence of glomerular sclerosis than non-responder.Their glomerular area,mesangial matrix index,interstitial collagen area density,diffusion distance from capillary to tubules,CD + 4 cell density were significantly less than those in the responders,but urinary space index,proximal epithelial cell area,glomerular capillary number and monocyte cell density were significantly higher in the responders than those in the non-responders.Conclusions:Nephrotic synerome of IgA nephropathy had different outcomes that are associated with clinical,pathological features and immune pathogenesis.