Clinicopathological analysis on adult IgA nephropathy patients with mild urinary abnormalities

Abstract

Objective Mild urinary abnormalities are very common in clinical practice,and IgA nephropathy is the most common reason of mild urinary abnormalities in adults.Whether the patients are necessary to receive renal biopsy was controversial.In order to clarify this issue,the clinical significance of renal biopsy in mild urinary abnormalities in patients with IgA nephropathy was investigated Methods Fifty-three patients with IgA nephropathy were selected from 77 patients with mild urinary abnormalities whose renal pathological diagnosis was confirmed.The 53 patients with IgA nephropathy were divided into there group,including proteinuria with single microscopic hematuria group,single microscopic hematuria group and single proteinuria group,according to their clinical manifestations.Renal pathological severity of the 53 patients was also evaluated using the Lee’s classification and the Oxford classification of IgA nephropathy.Whether the pathological classification of IgA nephropathy was different among three clinical manifestations was analyzed at last Results Renal pathological diagnosis of 77 patients could be confirmed in 91 patients with mild urinary abnormalities who received renal biopsy.There were 53(68.8%) cases of IgA nephropathy,including 39 patients(73.6%) with proteinuria in single microscopic hematuria group,5 patients(9.4%) in single microscopic hematuria group and 9(17.0%) in single proteinuria group.According to Lee’s pathological classification,Lee’s class Ⅲ was the most common classification,counting for 54.7%(29 patients),followed by class Ⅱ(14 patients,26.4%) and class I(5 patients,9.4%).However,the severe grades,class Ⅳ and classV,accounted for 3.8%(2 patients) and 5.7%(3 patients) respectively.There was no significant difference in the Lee’s classification and the Oxford classification among three groups with different clinical manifestations(P>0.05 for all).Conclusions Different clinical manifestations can not be acted as standard to distinguish the severity of renal lesions in IgA nephropathy patients with mild urinary abnormalities.Renal biopsy should be performed on those patients without contraindication in order to screen out the patients with severe renal lesion of needing immunosuppressant treatment