Clinical and Pathological Analysis of IgA Nephropathy Patients with Nephrotic Syndrome

Objective:To study the clinical and pathological characteristics of IgA nephropathy patients with nephrotic syndrome and the clinical risk factors associated with the renal pathologic lesions.Method:118 patients with nephrotic syndrome were collected from the inpatients who were diagnosed as IgA nephropathy by renal biopsy.The clinical and pathological features of patients were analyzed.And the clinical index of different severity of renal pathologic lesions was compared;the relationship between renal pathologic lesions and clinical factors were studied;the predicted factors were analyzed by step-wise multiple variance regression analysis.Results:The incidence of hypertension,renal failure,full field of microscopic hematuria was lower in group A than those in group B(11.8% vs 63.1%,15% vs 41.7%,14.7% vs 50%,respectively.P0.01).But the incidence of urinary protein(UP)≥6 g/24 h was higher in group A than that in group B(58.8% vs 32.1%,P0.01).Mean arterial pressure(MAP),serum creatine(Scr)were lower in group A than those in group B(P0.01),urinary protein excretion,hemoglobin were higher in group A than those in group B(P0.01).MAP,UP6 g/24 h,microscopic hematuria 5.0×107/L were independent predictors of the severity of renal pathologic lesion in IgA nephropathy patients with nephrotic syndrome(OR=1.048,3.227,6.578,P=0.034,0.047,0.002.respectively.)Hemoglobin was a favorable factor for renal pathologic lesion.Meanwhile,with the decreasing of hemoglobin,the increasing of hypertension and number of microscopic hematuria the renal pathologic lesion are more severe.Conclusion:IgA nephropathy patients with nephrotic syndrome have different clinical manifestations and pathologic lesions;patients with decreased hemoglobin,accompanied by hypertension and mass microscopic hematuria have more severe renal lesions.