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Clinical and pathological features of idiopathic membranous nephropathy in young people
Author(s) -
Lin Chu,
Zheng Danxia,
Wang Yue,
Wang Song
Publication year - 2019
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13486
Subject(s) - medicine , membranous nephropathy , pathological , proteinuria , renal biopsy , gastroenterology , biopsy , young adult , age groups , kidney , demography , sociology
Aim To investigate the clinico‐pathological features of idiopathic membranous nephropathy (IMN) in youth. Methods Patients with biopsy‐proven IMN in Peking University Third Hospital from May 2015 to October 2017 ( n = 147) were enrolled in this study. Patients were divided into youth (≤35 years old), middle‐age (35–65 years old) and elderly group (>65 years old) accordingly. Medical records of patients were retrospectively analyzed. Results Youth group exhibited shorter duration from onset to biopsy (3.49 ± 4.25 months in youth vs 8.71 ± 12.24 months in elderly) and milder clinical presentations in terms of less proteinuria and higher serum albumin ( P < 0.05). Furthermore, lower anti‐phospholipase A2 receptor (PLA2R) antibody titre (65.36 ± 101.14 RU/mL in youth vs 137.45 ± 215.12 RU/mL in middle‐age), less C3 deposits (35.14% in youth vs 65.00% in elderly) and higher 6‐month remission rate (63.64% in youth vs 36.00% in middle‐age) were observed in youth ( P < 0.05). Multiple linear regression confirmed C3 deposits ( P = 0.005) and anti‐PLA2R ( P = 0.040) were independent factors influencing proteinuria, and age is an independent influencing factor for time from onset to biopsy ( P = 0.043). Older age (OR = 2.044, 95% CI: 1.073–3.896, P = 0.030) and higher anti‐PLA2R (OR = 1.413, 95% CI: 1.020–1.959, P = 0.038) were significantly associated with non‐remission by 6 months. Conclusion Younger patients with IMN tend to have rapider onset and quicker remission than older patients. Milder clinical presentations in youth are associated with lower anti‐PLA2R antibody titre and less C3 deposits.