Analysis of 4931 renal biopsy data in central China from 1994 to 2014

The purpose of this study is to investigate the changing spectrum and clinicopathologic correlation of biopsy-proven renal diseases in central China. We retrospectively analyzed data of 4931 patients who underwent renal biopsy in ten hospitals between September 1994 and December 2014. Among them, 81.55% were primary glomerular diseases (GD), and 13.02% were secondary GD. IgA nephropathy (IgAN) was the most common primary GD (43.45%), followed by focal glomerulonephritis (16.79%), mesangial proliferative glomerulonephritis (MsPGN, 14.35%), and membranous nephropathy (MN, 13.28%). IgAN was leading primary GD in patients under 60 years old, while MN was the leading one over 60 years old. The most frequent secondary GD was lupus nephritis (LN) (47.35%). The prevalence of IgAN, MN and minimal change disease was found to increase significantly (p?<?0.001, p?<?0.001, and p?<?0.01, respectively), while that of MsPGN, membranoproliferative glomerulonephritis and LN decreased significantly (p?<?0.001, p?<?0.001, and p?<?0.05, respectively). The main indication for renal biopsy was proteinuria and hematuria (49.03%), followed by nephrotic syndrome (NS, 20.36%). IgAN was the most common cause in patients with proteinuria and hematuria, chronic-progressive kidney injury, hematuria and acute kidney injury; and MN was the leading cause of NS. Primary GD remained the predominant renal disease in central China. IgAN and LN were the most prevalent histopathologic lesions of primary and secondary GD, respectively. The spectrum of biopsy-proven renal disease had a great change in the past two decades. Proteinuria and hematuria was the main indication for renal biopsy.     

Natural history of immunoglobulin A nephropathy and predictive factors of prognosis: a long-term follow up of 204 cases in China

Aim: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. However, its natural history and risk factors are not well understood. Our aim was to identify the clinical and pathological factors that could predict disease prognosis in Chinese patients. Methods: We studied 204 biopsy‐diagnosed IgAN patients, who were followed for an average of 6.1 years (range, 4–15 years). Chronic kidney disease (CKD) classified according to the Kidney Disease Outcomes Quality Initiative practice guidelines. Renal pathological lesions were graded single‐blindedly according to the Haas classification. The glomerular filtration rate was estimated by the Modification of Diet in Renal Disease equation for Chinese subjects. Results: Patients with CKD were classified as stage 1 (38.10%), stage 2 (35.40%), stage 3 (13.30%), stage 4 (9.90%) and stage 5 (3.30%). During the follow up, 31 patients had progressed to end‐stage renal disease. The renal survival rate following biopsy was 85.1% at the fifth year, and 77.1% at the 10th year. Univariate analysis indicated that patients who were male, had hypertension, proteinuria of more than 1 g/day, renal impairment (estimated glomerular filtration rate, <60 mL/min.1.73 m²), and a high histological grading were associated with poor prognosis. Multivariate analysis indicated that the relative risk of renal failure for patients was 3.9 (P = 0.000) for patients with renal impairment, 2.8 (P = 0.019) for patients with hypertension, and 2.0 (P = 0.003) for patients with high histological grading. Conclusion: We described the natural history of IgAN through follow ups of a relatively large cohort of patients. Most patients were biopsied at an early stage; however, the long‐term prognosis was still poor. Patients with renal impairment, hypertension and advanced histological involvement had the highest risk for disease progression.     

Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies

Renal biopsy specimens of 13,519 cases were collected during the period of January 1979 to December 2002 from the Research Institute of Nephrology, Nanjing University School of Medicine, Nanjing, China. Analysis of the data of this group of patients showed that primary glomerulonephritis (GN) remained the most important and prevalent renal disease in China. The ratio of primary to secondary GN was 2.75:1. However, it is declining progressively in the past two decades with an increment in the incidence of diabetic nephropathy and nephrosclerosis. IgA nephropathy (IgAN) constituted 45.26% of the primary GN, while non-IgA mesangial proliferative lesions were 25.62%. Membranous nephropathy was 9.89% and minimal change disease was 0.93%, remarkably less. The most prevalent etiology of secondary GN was systemic lupus erythrematosus (SLE) (54.3%) followed by Henoch-Sch?nlein purpura (20.3%), diabetic nephropathy (6.6%), systemic vasculitides (4.0%), and amyloidosis (2.2%). Based on the study of biopsy materials obtained from 607 cases manifesting chronic renal failure, IgAN was identified as the most frequent cause (26.69%) of chronic renal failure.     

慢性肾脏病患者中慢性前列腺炎的发生率及其影响因素

目的：研究慢性肾脏病（CKD）患者中慢性前列腺炎（CP）的发生率及其影响因素。方法：对273例明确病理诊断的CKD男性患者进行前列腺液常规检查，比较不同类型肾脏病、不同年龄段和不同程度蛋白尿、血尿、肾功能对CP发生率的影响。结果：273例CKD患者中91例患者伴有CP，总的发生率33．3％；膜性肾病患者CP发生率最高60．0％，较非IgA肾病的系膜增生性肾小球肾炎（25．5％）、乙肝相关性肾炎（24．2％）及局灶节段肾小球硬化症患者（0％）高（P〈0．05）。IgA肾病（IgAN）患者CP发生率39．7％较非IgA系膜增生性肾小球肾炎患者高（P〈0．05）。随年龄增加CP的发生率升高但是各组间无统计学差别；不同程度蛋白尿、血尿、肾功能组间CP的发生率无差别。结论：CKD是CP的高发人群，随年龄增加CKD患者中CP的发生率有增加的趋势，肾脏病病理类型是影响CP的发生率的主要因素；CP与部分CKD间存在一定的联系。     

Role of uteroglobin G38A polymorphism in the progression of IgA nephropathy in Japanese patients

BACKGROUND: Uteroglobin is a multifunctional protein and both its gene knockout and antisense transgenic mouse models develop the pathological and clinical features of IgA nephropathy. A genetic polymorphism in uteroglobin has been reported to be associated with progression of IgA nephropathy in a Caucasian population, but the findings remain controversial. METHODS: Genomic DNA was isolated from 595 individuals including 239 patients with IgAN, 160 patients with glomerulonephritis distinct from IgAN, and 196 healthy controls. The uteroglobin G38A genotype was determined by PCR-RFLP with Sau96I. To examine the possible association of uteroglobin gene polymorphism in the patients with and without IgAN, the uteroglobin genotype and allele frequency were compared between the two groups. In addition, associations between the polymorphism and blood pressure, proteinuria and prognosis of renal function were analyzed in the patients with IgAN to investigate the role of this gene polymorphism in the risk of progressive renal dysfunction in IgAN patients. RESULTS: The Cox proportional hazard regression model revealed that hypertension and proteinuria at the time of renal biopsy were independent risk factors for poor renal survival. Uteroglobin genotype was not significantly associated with the renal survival rate. However, in the patients with heavy proteinuria (more than 2 g/day) or in those with hypertension at the time of renal biopsy, the renal survival of patients with the GG genotype was significantly worse than the other genotypes. CONCLUSION: Uteroglobin GG genotype may be a genetic marker for rapid disease progression to end-stage renal failure, especially in the IgAN patients with heavy proteinuria or high blood pressure.     

The spectrum of children's kidney diseases—9925 renal biopsy-proven cases from a single center of China between 2004 and 2017

Objective To analyze the spectrum of children's kidney pathology by renal biopsy. Methods The clinical and pathological data of the cases in Jinling Hospital involving the patients younger than 18 years old who received renal biopsy from April 1st, 2004 to December 31th, 2017 were retrospectively collected, and compared with the renal pathological data of 1611 children aged 0-18 years from June 1982 to March 2004. Results This study included 9925 cases of kidney diseases proven by renal biopsy. The ratio of male to female was 1.79∶1. Primary glomerulonephritis (PGN) accounted for 66.14%, and secondary glomerulonephritis (SGN) accounted for 28.00%. Top five of the PGN were IgA nephropathy (IgAN, 19.11%), mesangial proliferative glomerulonephritis (MsPGN, 16.07%), minimal change disease (MCD, 14.20%), focal segmental glomerulosclerosis (FSGS, 6.19%) and membranous nephropathy (MN, 4.70%) in whole children, IgAN (13.12%), MsPGN (11.20%), MCD(10.63%), FSGS (4.55%) and MN (2.54%) in males, and IgAN (5.99%), MsPGN (4.87%), MCD (3.57%), MN (2.16%) and FSGS (1.63%) in females. Top three of the SGN were Henoch-Schonlein purpura nephritis (HSPN, 17.74%), lupus nephritis (LN, 8.23%) and vasculitis nephropathy (1.82%). The male was in a dominant position in all kinds of pathologic types than female except LN. HSPN was the most frequent type in adolescents between 6-13 years old. LN was the commonest one in 14-18-year-old girls, while IgAN was the the most common in 14-18-year-old boys. Post infective nephritis was the most popular in 12-14-year-old teenagers. It was also found that MN ascended in female. When compared with the data before 2004, HSPN and LN accounted for a greater proportion in SGN, post infective nephritis displayed a smaller proportion. Conclusions PGN is the mainly kind of glomerular disease as before, and immune disorder related to glomerular diseases increase and post infective nephritis decreases in proportion. This study provides the reference and epidemic data for diagnosis, treatment and prevention of children's renal diseases.     

Immunoglobulin A nephropathy complicating ulcerative colitis

Ulcerative colitis is rarely associated with immunoglobulin A nephropathy (IgAN). The development of IgA nephropathy complicates further the clinical course of patients with ulcerative colitis. A 72-year old man with a 30-year history of ulcerative colitis requiring colectomy and modest renal insufficiency secondary to complications of nephrolithiasis and renal artery stenosis developed glomerular hematuria, proteinuria and progressive renal failure. Percutaneous kidney biopsy revealed IgAN with extensive glomerular and interstitial sclerotic changes. After resection of a chronically infected ileo-rectal pouch, renal function improved, while hematuria and proteinuria gradually disappeared without specific treatment of the IgAN. The manifestations of IgAN complicating ulcerative colitis can be improved with effective treatment of the bowel disease even when there are extensive sclerotic changes in the kidneys.     

四川地区肾活检2330例临床病理分析

目的：探讨四川地区肾穿刺活检病理类型的分布特点以及疾病谱的变迁。方法回顾性分析2330例肾活检患者的临床病理资料,分析本地区肾脏疾病的临床病理特征。结果2330例肾活检患者中,男女比例为1∶1.15,发病高峰年龄为20~40岁。2330例患者中,原发性肾小球疾病1896例（占81.37%）,常见的病理类型依次为 IgA 肾病820例（占35.19%）、系膜增生性肾小球肾炎372例（占15.97%）、膜性肾病298例（占12.79%）、微小病变肾病200例（占8.58%）和局灶节段性肾小球硬化症78例（占3.35%）;继发性肾小球疾病367例（占15.75%）,以狼疮性肾炎最常见（134例,占5.88%）,其次为紫癜性肾炎127例（占5.45%）、糖尿病肾脏疾病35例（占1.5%）和淀粉样变性肾病20例（占0.86%）;肾小管间质疾病50例（占2.15%）;遗传性肾病17例（占0.73%）。2330例肾脏疾病患者的临床表现依次为肾病综合征1015例（占43.56%）、慢性肾炎综合征681例（占29.22%）、急性肾炎综合征392例（占16.82%）、隐匿性肾小球肾炎121例（占5.29%）、慢性肾衰竭72例（占3.09%）、急性肾衰竭47例（占2.02%）。近年来,膜性肾病构成比呈逐渐增加趋势。结论本地区肾脏疾病多见于青壮年,以原发性肾小球疾病最常见,其中 IgA 肾病和系膜增生性肾小球肾炎是最多见的病理类型,膜性肾病的检出率有增高趋势。继发性肾小球疾病以狼疮肾炎和紫癜性肾炎最常见。     

Related factors of hyperuricemia in IgA nephropathy patients

Objective To investigate the influencing factors of hyperuricemia in patients with IgA nephropathy (IgAN). Methods A retrospective study was performed in patients with renal biopsy diagnosed as IgAN in the Department of Nephrology, Provincial Hospital of Anhui Medical University from January 2016 to October 2018. According to the blood uric acid level, they were divided into two groups: patients with hyperuricemia and patients without hyperuricemia. The general clinical indicators and renal pathological data were compared between the two groups. Logistic regression model was used to analyze the influencing factors of hyperuricemia in IgAN patients. Results A total of 125 IgAN patients with age of (35.70±11.16) years old were enrolled, including 63 males and 62 females. The morbidity of hyperuricemia was 44.0%(55/125). Compared with the normal blood uric acid group, the blood urea nitrogen, serum creatinine and the proportion of chronic kidney disease (CKD) stage 3-5, small arterial wall thickening, fibrous crescents/globules, renal interstitial fibrosis, renal tubular atrophy, glomerular sclerosis and inflammatory cell infiltration in the hyperuric acid group were higher, while the level of estimated glomerular filtration rate (eGFR) was lower. And the differences were statistically significant (all P＜0.05). Multivariate logistic regression analysis showed that the level of serum creatinine was an independent related factor of hyperuricemia in IgAN patients (OR=1.034, 95%CI 1.005-1.064, P=0.021). Conclusions IgAN patients with hyperuricemia presented more severe glomerular, tubular and interstitial lesions, and the level of serum creatinine is an independent related factor of hyperuricemia in IgAN patients. High uric acid level may have an important influence on the progression of IgAN, so good control of serum uric acid may improve the prognosis of patients with IgAN.     

Polymorphism of renin-angiotensin system genes in IgA nephropathy

BACKGROUND AND AIMS: Individuals are prone to disease because of certain disease-susceptible genes. The angiotensin I-converting enzyme (ACE) gene insertion/deletion (I/D), the angiotensinogen (AGT) gene, M235T, and the angiotensin II type 1 receptor (ATR) gene, A1166C, polymorphisms have been associated with IgA nephropathy (IgAN) and its progression. Several studies on Caucasians and Japanese patients have reported contradictory results. We determined these polymorphisms in 118 Chinese patients with IgAN and 94 healthy Chinese subjects to assess their clinical impact. METHODS: Genotyping was performed with DNA isolated from peripheral leucocytes, polymerase chain reaction amplification of the polymorphic sequence, restriction enzymes digestion, and separation and identification of DNA fragments. Clinical data at renal biopsy and final status on renal function were determined from patients' records. RESULTS: Comparing all IgAN patients with controls, AGT and ATR genotype distributions were similar, whereas there was a significant increase in the ACE DD genotype (P < 0.05). When comparing patients with end-stage renal failure (IgAN-ESRF) and those without (IgAN-nonESRF), there was no difference among the three gene polymorphisms. In contrast, there were significant differences in higher male prevalence (P < 0.05), increased serum creatinine at presentation (P < 0.05), more sclerosis (P < 0.01) and higher tubulointerstitial lesion score (P < 0.001) in the IgAN-ESRF group. CONCLUSION: Among the ACE, AGT and ATR gene polymorphisms, only the DD genotype may predispose the individual to IgAN in the Chinese population. None are significant for prognosticating ESRF.     

固本通络冲剂治疗IgA肾病的疗效特点分析

目的：研究中药复方固本通络冲剂治疗IgA肾病的疗效特点。方法：对肾活检证实的IgA肾病息随机分为固本通络冲剂治疗组(50例)及潘生丁对照组(30例)进行疗效特点分析，疗程3个月。结果：其疗效特点为对病理损害轻，临床表现为持续镜下血尿伴少量蛋白尿，中医辨证为气阴两虚的病人疗效最好；而对病理损害重，临床表现为肾病综合征，中医辨证为脾肾气虚疗效差。结论：固本通络冲剂对临床表现为持续镜下血尿伴少量蛋白尿，中医辨证属气阴两虚更为适宜。     

Is IgA nephropathy the commonest primary glomerulopathy among young adults in the USA?

Over the past decade, focal segmental glomerulosclerosis (FSGS) has emerged as the most common primary glomerulopathy in adults in the USA. However in our practice, we became aware of increased numbers of patients with IgA nephropathy (IgAN). In order to further examine this, a retrospective analysis of renal biopsy diagnoses from adults was done from our biopsy database. Adult renal biopsies received from 3/1/2001 to 2/28/2005 were analyzed to determine the frequency of common primary glomerulopathies, which included FSGS, IgAN, membranous nephropathy (MN), minimal change disease, and membranoproliferative glomerulonephritis Type I (MPGN). The patients were grouped as all adults (>or=20 years) and young adults (20-39 years). The distribution of common primary glomerulopathies among the two age groups, expressed as a percentage of all non-transplant diagnoses (n = 4,504), was IgAN 6.9/3.4%, FSGS 9.6/3.2%, MN 6.8/1.6%, minimal change disease 2.5/0.9%, MPGN 1.2/0.2%. IgAN was as common as FSGS in young adults in our biopsy population (IgAN/FSGS 154/143 1.08:1). IgAN was the most common primary glomerulopathy in young adult Caucasians (IgAN/FSGS 2.1:1). IgAN was also the most common cause of end-stage renal disease (ESRD) in young adult Caucasians. In contrast, IgAN was rare in African Americans in whom FSGS remains more common (FSGS/IgAN 9.7:1). These findings from a large renal biopsy referral center serving 24 Midwestern and Southern states suggest that IgAN may be the most common primary glomerulopathy and the most common cause of ESRD in young adult Caucasians in the USA.     

Treatment of IgA nephropathy

IgA nephropathy (IgAN) is an important cause of progressive kidney disease with 25-30% of patients developing end-stage renal disease within 20 years of diagnosis. There is still no treatment to modify mesangial IgA deposition and available treatments are those extrapolated from the management of other patterns of chronic glomerulonephritis. There remains no consensus on the use of immunosuppressive agents for treatment of progressive IgAN and this is compounded by the relative lack in IgAN of randomized controlled trials relevant to current clinical practice. Patients with recurrent macroscopic hematuria or isolated microscopic hematuria and proteinuria <1 g/24 h require no specific treatment. Those with nephrotic syndrome and minimal change on renal biopsy should be managed as for minimal change nephropathy. There is no evidence to support the use of corticosteroids for nephrotic IgAN outside this group of patients. Patients presenting with acute renal failure require evaluation to distinguish acute tubular necrosis, which requires supportive therapy only, from crescentic IgAN, for which treatment with cyclophosphamide and corticosteroids in a regimen similar to that for renal small vessel vasculitis is indicated in the absence of significant chronic histologic injury. Patients at greatest risk of progressive renal impairment are those with hypertension, proteinuria >1 g/24 h, and reduced glomerular filtration rate at diagnosis. All such patients should be treated to a blood pressure of 125/75 mm Hg with dual blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibition and angiotensin receptor blockade. At present, there is insufficient evidence for the additional use of immunosuppressive agents, antiplatelet agents, or anticoagulants.     

IgA Nephropathy in India: What We Do Know

Background: Even though IgA nephropathy (IgAN) is not the most common primary glomerulonephritis (GN) in India, the outcome of patients with IgAN in India is poor when compared with other parts of the world, which is a burden in itself. Methods: Basic and clinical research work in India on primary IgAN was systematically reviewed. Comparisons between data from India and those from other countries were made. Results: IgAN constitutes between 7% and 16% of most biopsy samples from India, bearing in mind these figures may represent only the tip of the iceberg. Nephrotic syndrome and renal failure seem to be common presenting features. The renal survival rates appear to be dismally low. DD genotype of angiotensin-1 converting enzyme (ACE) gene may predispose the individual to IgAN in Indian population. As might be expected, IgAN can recur posttransplant though the posttransplant course is indolent. There are no data on the treatment aspects of IgAN. Conclusion: Low incidence but marked severity characterizes IgAN in India. It is apparent that IgAN seems to have a poor outcome in India. What we are unsure of is the reason behind it. In-depth basic studies and multicenter clinical trials are needed to address this bizarre pattern.     

合并慢性前列腺炎的慢性肾脏病患者临床病理特点

目的：探讨合并慢性前列腺炎（CP）的男性慢性肾脏病（CKD）患者临床病理特点。方法：比较伴CP与不伴CP的CKD患者的年龄、婚姻情况、蛋白尿、血尿、肾功能水平及病理类型等临床病理指标。结果：（1）合并CP组平均年龄较不伴CP组大[（232.6±12.7）岁vs（9.5±11.4）岁],CP组已婚率高（63.7%vs47.3%）（P均〈0.05）;大量蛋白尿（〉3.5g/24h）52例（57.1%）,CP组中最常见的3种肾脏病为IgA肾病31例（34.1%）,非IgAN系膜增生性肾小球肾炎24例（26.4%）,膜性肾病12例（13.2%）,其中膜性肾病的发生率较不伴CP组（4.4%）高（P〈0.05）;伴CP的IgAN患者血管襻IgA沉积率较不伴CP患者高（P〈0.05）。（3）CP组与不伴CP组在蛋白尿、血尿、肾功能方面比较差异无统计学意义。结论：伴CP的CKD者年龄较大,多为已婚,半数伴大量蛋白尿,具有一定的临床病理特点,CP可能造成某些CKD患者慢性化改变。     

Recurrence of IgA nephropathy 17 months after renal transplantation in the allograft transmitted thin basement membrane disease (TBMD) from donor

Recurrence of IgA nephropathy (IgAN) following renal transplantation has been described in 40-50% of such patients and it usually has a good outcome. We present the case of a 20-yr-old woman with IgAN who developed end-stage renal failure in 1995. In November 1996, she received a kidney from a living-related donor and was treated with tacrolimus, azathioprine and steroids. Zero- and one-hour biopsies were performed, which revealed minor glomerular abnormalities in light microscopy, thin basement membrane disease (TBMD) in electron microscopy. Eight months later she developed microscopic hematuria and proteinuria; however, the graft function was normal. Renal biopsy revealed an IgAN that is thought to be due to recurrence of the original disease.     

Higher HOMA-IR index and correlated factors of insulin resistance in patients with IgA nephropathy

Objective: To investigate the index of homeostasis model of insulin resistance (HOMA-IR) in IgA nephropathy (IgAN) patients, and to explore the possible correlated factors contributing to insulin resistance (IR) within these patients. Material: There were 255 IgAN patients and 45 membranous nephropathy (MN) patients in our database. We identified 89 IgAN subjects and 21 MN subjects without diabetes and undergoing glucocorticoid therapy for at least 6 months. Methods: Data regarding physical examination, blood chemistry and renal pathology were collected from 89 IgAN subjects and 21 MN subjects. Then 62 IgAN patients and 19 MN patients with chronic kidney disease (CKD) Stage 1 - 2 were selected for the comparison of HOMA-IR index, 89 IgAN patients were selected for multiple regression analysis to test for correlated factors of HOMA-IR index with IgAN patients. Results: Comparison between IgAN and MN show that HOMA-IR index was significantly higher in IgAN patients with CKD Stage 1 - 2. After logarithmic transformation with urine protein (UPr), Ln(UPr) (b = 0.186, p = 0.008), eGFR (b = -0.005, p = 0.014), > 50% of glomeruli with mesangial hypercellularity (b = 0.285, p = 0.027) and body mass index (BMI) (b = 0.039, p = 0.008) were correlated factors of HOMA-IR index in the multiple regression analysis. Conclusion: IgAN patients had higher HOMA-IR index compared with MN in the stages of CKD 1 - 2. For IgAN patients, more UPr, lower eGFR, > 50% of glomeruli with mesangial hypercellularity and higher BMI were correlated with IR.     

穿通支原体感染与IgA肾病临床病理的关系

目的 研究穿通支原体（Mycoplasma penetrans,Mpe）感染与IgA肾病（IgAN）患者临床病理改变的关系。 方法 采集经病理检查确诊的IgAN患者118例、健康体检者89例和慢性肾脏病（CKD）90例的血液标本,用试剂盒方法提取血清DNA。用PCR技术检测Mpe p35脂蛋白,对阳性标本采用Southern 印迹方法进行验证。根据IgAN患者Mpe感染情况分为阳性组和阴性组,结合患者的临床病理资料进行分析。 结果 89例健康体检者中仅1例Mpe p35脂蛋白为阳性,阳性率为1.1%。90例CKD患者中2例阳性,阳性率为2.2%。118例IgAN患者中19例阳性,阳性率为16.0%,显著高于健康组及CKD组,差异均有统计学意义（均P ＜ 0.01）。Mpe阳性组42.1%患者临床表现为肉眼血尿,显著高于Mpe阴性组（P ＜ 0.01）。Mpe阴性组24 h尿蛋白量、Scr、Lee病理分级显著高于阳性组,差异均有统计学意义（均P ＜ 0.05）。两组间肾小管、肾间质及肾血管积分差异无统计学意义。 结论 IgAN患者的Mpe检出率显著高于健康体检者和CKD患者。Mpe阳性患者更多表现为发作性肉眼血尿。Mpe感染可能与IgAN的发病有关。