Clinical and pathological features of young patients with idiopathic membranous nephropathy in 20 cases

Objective To investigate the clinical and pathological features of idiopathic membranous nephropathy (IMN) in young patients. Methods Clinical data of 20 young patients, 16 to 44 years, who were diagnosed as IMN admitted to the Zhejiang Provincial People's Hospital from January 2013 to December 2014 were retrospectively analyzed, comparing to 55 mid-aged patients who were diagnosed as IMN during the same period in the hospital. Clinical and pathological features of above mentioned patients were analyzed. Results Young patients with IMN accounted for 26.7% of IMN patients. Compared to mid-aged patients, young patients with IMN had lower proportion of hypertension (P=0.003), lower blood glucose level (P=0.010), higher estimated glomerular filtration rate (eGFR) and low-density lipoprotein (LDL) (P=0.012, P=0.038), and lower levels of T3 and T4 (P=0.030, P=0.034). Furthermore, there were less sclerosis glomeruli (P＜0.001), hyaline change of arteriole (P=0.040) and arteriolar wall thickening (P＜0.0001), lower positive ratios of IgA (P=0.008), and more without renal tubulointerstitial lesions (P=0.018) in young patients. There were no statistically significant differences between these two groups in other index. Conclusions Compared to mid-aged patients, young patients with IMN have better blood pressure and blood glucose level, higher glomerular filtration rate and LDL. Moreover, thyroid function is significantly affected, meanwhile the lesions of glomerular, interstitial and vascular are mild in young patients.