Although membranoproliferative glomerulonephritis is one of the important causes of chronic renal failure, there has been on report about the clinical features of idiopathic membranoproliferative glomerulonephritis in Korean adults.
We retrospectively analyzed the clinical, laboratory and pathological data of 22 patients in whom a histological diagnosis of membranoproliferative glomerulonephritis (MPGN0 was established by renal biopsy in Seoul National University Hospital
from
1979
to 1991.
The total number of primary glomeerulonephritis patients during the same period was 1361 and the idiopathic MPGN accounted for 1.6% (22/1361) of it Male to female ratio of the patients was 1.2:1 and mean age at the diagnosis was 34.1±15
(mean±SD)
years with a wide age range (16~670 but 50% of the patients were under the age of 30. The clinical presentations at the diagnosis were nephrotic syndrome (16/22), acute glomerulonephritis (4/22), asymptomaitc urinary abnormality (1/22) and
chronic
glomerulonephritis (1/22). On physical examination, hypertension (14/22), gross hematuria (5/22), and edema (15/22) were frequently noticed. As laboratory features, anemia (18/22), microscopic hematuria (16/22) and azotemia (11/22) were observed
and
serum C3, C4 and Ch50 level were depressed in 24% (5/22), 20% (4/22) and 41% (7/17) of cases respectively. On histological examination, all the cases belonged to MPGN type I and on dense deposit variant was seen. And segmental sclerosis, global
sclerosis and crescents were found in 32% (7/22), 68%(15/22) and 36%(8/22) of the cases respectively. Immunofluorescent examination was performed in 18 cases. C3 deposits along the peripheral capillary walls were detected in all cases and IgG,
IgA,
IgM
in 78% (14/18), 33%(6/18) and 50% (9/18) of the cases respectively. On 16 electron microscopic examination, subendothelial electron dense deposition, subendothelial electron dense deposition was noted in all cases except one which showed a
feature
of
advanced sclerosing glomerulonephritis and subepithelial and mesangial electron dense depostion in 56% (9/16) of the cases. Of the 20 patients whose follow-up period was over 3 month, 6 patients died or required dialysis after a mean duration of
31.5
months (range, 9~57 months) from the diagnosis. Among the clinical, laboratory, and pathologic parameters, azotemia, hypertension and creacents at the diagnosis were more frequently observed in deteriorating cases but no statistical significance
was
found. The actuarial renal survival of these 20 patients was 66.5% after 3 years and 26.2% after 5 years respectively.
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