Clinical and pathology features of membranous nephropathy: An analysis of 69 cases

Objective To investigate the clinical and pathological features of membranous nephropathy (MN) in adults. Methods Clinical data about 69 patients who were diagnosed as membranous nephropathy admitted to The First Affiliated Hospital of Liaoning Medical university from July 2010 to July 2013 were retrospectively analyzed, including their age, gender, serum albumin, proteinuria, hypertension, urinary occult blood, clinical performance, pathological manifestations and laboratory test results. Results The mean age of 69 patients was 46.2±14.2 years old with a male to female ratio of 1.875∶1 (45 males and 24 females). Idiopathic membranous nephropathy (IMN) accounted for 79.7% (55 cases) of the total renal patients biopsied, and secondary membranous nephropathy (SMN) accounted for 20.3% (14 cases), including 7 cases (50.0%) of hepatitis B virus-related membranous nephropathy (HBVMN) and 1 (7.1%) case of Type V lupus nephritis (V-LN). Of the 69 patients, 54 cases (78.26%) performed as nephritic syndrome (NS), 15 cases (21.74%) as glomerulonephritis syndrome, accompanied by microscopic hematuria in 21 cases (30.43%), hypertension in 17 cases (24.64%), renal insufficiency in 4 cases (5.80%). The pathological characteristics showed that phase Ⅰ membranous nephropathy (MN) accounted for 36.2% (25 cases), phase Ⅱ membranous nephropathy accounted for 43.5% (30 cases), and phase Ⅲ as well as phase Ⅳ were not collected. There were excessive deposits of IgG and C3 in kidney tissues in 69 cases (100%) and 65 cases (94.2%), respectively. 21 cases (30.4%) were IgA deposition and 18 cases (26.1%) were IgM deposition. The expression of HBsAg and (or) HBcAg were showed under the hepatitis B virus-associated membranous nephropathy (HBVMN). It suggested that the pathological stages of male aged patients with hypertension and high quantity of 24-hour proteinuria were higher (P＜ 0.05). Conclusion Membranous nephropathy often occurs in middle and old aged men. The main pathological stages are in phase Ⅰ and phase Ⅱ, and the main cases of SMN is HBVMN. Both IMN and SMN perform as nephrotic syndrome. Elder male patients with hypertension and high quantity of 24-hours proteinuria have higher degree of membranous nephropathy stages.