SP146CHARACTERISTICS OF THE PATIENTS WITH MEMBRANOUS GLOMERULONEPHRITIS - REPORT FROM THE CROATIAN REFERRAL CENTRE

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INTRODUCTION AND AIMS: Membranous glomerulonephritis (MGN) still remains one of the leading glomerulonehritides in adults. This study was aimed to evaluate the demographic and clinical data, as well as pathohistological data in the patients with MGN, as well as to examine the possible differences between primary and secondary MGN. METHODS: Adult patients (18 years or older) who underwent kidney biopsy between 2002. and 2016., and were diagnosed with MGN in our hospital, were enrolled in the study. Demographic, clinical and pathohistological data from kidney biopsy was evaluated. Light, immunofluorescent and electronic microscopy analysis of the renal biopsy were performed. Pathological data studied were: the number of normal, focally sclerosed and globally sclerosed glomeruli, the percentage and the grade of interstitial fibrosis and tubular atrophy (IFTA), the grade of vascular changes, the grade of immunofluorescnet staining for IgA, IgM, IgG, C3, C1q, kappa and lambda chains, the degree of podocyte foot loss and finally the Ehrenreich-Churg class. The differences between primary and secondary MGN were examined with Mann-Whitney test and Chi-square or Fisher Exact test. RESULTS: There were 96 patients in total, among them there were 37 women (38.5%). The median age was 56 years (interquartile ratio IQR 46-63). 83 patients (86.5%) had primary MGN. The causes for the secondary MGN were: lupus (5 patients, 38.5% of the secondary MGN), tumors (5 patients), syphilis (1 patient, 7.7% of the secondary MGN), systemic sclerosis (1 patient) and sarcoidosis (1 patient). Median estimated glomerular filtration rate at diagnosis was 70.51 ml/minute (IQR 54.76-83.54) and median of maximal 24-hour proteinuria was 9.6 g (IQR 5.7-13.4 g). There were no significant differences found between patients with primary and secondary MGN regarding demographic and clinical variables (age, gender, clinical presentation, hypertension, hematuria, serum creatinine and estimated glomerular filtration rate, maximal 24-hour proteinuria, mean arterial pressure). Also, there were no significant differences found between primary and secondary MGN in forementioned pathohistological parameters. CONCLUSIONS: In our patient cohort clinical and pathohistological characteristics of patients with primary and secondary MGN did not differ significantly. Wide range of diagnostic test and procedures is needed to differentiate between two types of MGN. Our established database of patients with MGN should serve to futher improve the management and follow up of those patients.

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