Risk factors,Clinical and Pathological Analysis of IgA Nephropathy Presenting with Nephrotic Syndrome

Objective To study the clinical and pathological characteristics of IgA nephropathy patients with nephrotic syndrome and the relative risk factors.Methods Between June 1993 to 48 patients with nephrotic syndrome were collected from our department the inpatients who were diagnosised as IgA nephropathy by renal biopsy.The clinical and pathological features of patients were analyzed.And then all patients were divided into two groups,according to the clinical remission of treatment(group A,complete clinical remission group,n = 13;Group B,partial remission group,n = 35 ),clinical index of the two groups were compared, as well as the relationship between renal pathologic lesions and clinical factors were studied,and the predicted factors were analyzed,too.Results Among these patients,56.3%accompanied by hypertension, 20.8%with chronic renal failure.As for renal pathological changes,4 cases(13.6%) were GradeⅠ(Lee SM.classification),9 cases(18.8%) were GradeⅡ,6 cases(12.5%) were GradeⅢ,19(39.6%),10 (20.8%) were GradeⅣandⅤ,respectively.The partial remission group has more higher level of mean arterial pressure,serum creatinine,and incidence of mass hematuria than those of complete remission group. while,the excretion of urinary protein per day,level of hemoglobin were lower than those of group A.Scores of pathological lesion increased significantly in group B(P0.05 ).It showed that the proportion of type IgA + IgG + IgM immunopathologically of Group B is significantly higher than that of Group A(P0.001). Conclusion IgA nephropaty patients presenting with nephrotic syndrome have different clinical manifestations and pathologic lesions,Patients accompanied by hypertension,anemia,high serum creatine and mass hematuria, were the clinical risk factors for poor prognosis.The more poor of prognosis the more severity of renal lesions .with decreased hemoglobin have more severity renal lesions and immunopathological type of IgA + IgG + IgM is very common.