Clinical characteristics and prognosis of idiopathic membranous nephropathy in adolescent

Objective Idiopathic membranous nephropathy (IMN) is one of the most common causes of nephrotic syndrome in adults, but it is relatively rare in adolescent. The aim of this study was to elucidate the clinical features and prognosis of IMN in adolescent. Methods All patients were admitted to our hospital from January 2005 to December 2014 with biopsy proven IMN, and at least 12 months follow-up in this retrospective study. Adult patients with IMN were served as the controls, and their clinical manifestations, laboratory tests and prognosis were collected. Results ①The renal function of IMN in adolescent were normal at onset, they had lower serum albumin (P=0.0235) and serum IgG levels (P<0.0001) compared with adult IMN, but the peripheral blood CD4 and CD20 count were significantly increased (P=0.0256, P<0.0001), also there were no difference of 24 h urinary protein, renal tubular injury index and hematuria. ②The positive rate of PLA2R antibody in adolescent was 58.82% (40/68), which was similar to adults (P=0.857). ③Adolescent IMN were followed up 12~130 months (median 40 months), the total efficiency (complete and partial remission rate) was 88.89%(80/90), and the renal survival rate was 98.8% , 97.0% and 87.3% at 2, 3 and 6 years after renal biopsy. ④Multivariate Cox regression analysis showed that hypertension, urinary RBP, and renal creatinine were the independent risk factors for double creatinine. Conclusions The positive rate of PLA2R antibody in adolescent IMN is similar to that of adult IMN, and its treatment response and prognosis are similar to adult IMN. Key words: Glomerulonephritis, Membranous; Adolescent; Prognosis