Clinicopathological features and prognosis of idiopathic membranous nephropathy in adults

Objective To assess the clinicopathological features and their relations with the prognosis of idiopathic membranous nephropathy(IMN).Methods Retrospectively analyze 55 patients with IMN biopsied between March 2003 and March 2007,who were older than 16 years old and were followed up for more than 6 months.The Kaplan-Meier univariate analysis and COX proportional hazard was performed to identify predictive parameters.Results Of 55 IMN patients,63.6%(35 patients) had nephrotic syndrome;69.1%(38 patients) had microscopic hematuria,without macroscopic hematuria;38.2%(21 patients) had hypertension;4 patients had renal vein thrombosis,1 had pulmonary artery embolism.Pathological stages mainly were Ⅰ and Ⅱ stage,with proportion of 81.8%;47.3%(26 patients) had focal segmental glomerulosclerosis;Tubulo-interstitial and renal blood vessel lesions are mainly mild.The renal survival rates are 82.7% at 2 years and 38.9% at 5 years after biopsy.There is no significant difference among different treatment modes.Glomerular filtration rate at biopsy is an independent predictor for renal death or death.Conclusion The prognosis of IMN is poor.Glomerular filtration rate at biopsy is an independent predictor for renal prognosis.