Clinicopathological Study on Adult Nephrotic Syndrome

Oh, Kook Hwan; Ahn, Cu Rie; Yang, Jae Suk; Hwang, Dae Yeon; Han, Jin Suk; Kim, Suhng Gwon; Lee, Jung Sang; Lee, Hyun Soon

Abstract

We investigated the clinical features of nephrotic syndrome in Korea according to sex, age and pathologic diagnosis under the classification system supported by WHO. Adult nephrotic patients who underwent renal biopsy from 1979 to 1993 at the Department of Internal Medicine, Seoul National University Hospital, with the exception of diabetic nephropathy and multiple myeloma, were analyzed in terms of their clinical manifestations, laboratory data, and pathologic features. 1) The number of our total nephrotic patients was 956 and their mean age was 32.6. Male to female ratio was 1.96:1. 2) Among total nephrotic syndrome patients, there were 736 (77%) primary NS and 220 (23%) secondary NS patients. 3) The pathologic diagnoses of the primary NS were minimal change nephrotic syndrome (41.6%), membraneous nephropathy (20.9%), focal glomerulosclerosis (17.3%), IgA nephropathy (9%), membranoproliferative GN (4.5%), sclerosing GN (2.4%), and mesangial proliferative GN (2.2%). 4) Among primary NS patients with ages between 15 and 40, the percentage of minimal change nephrotic syndrome was highest(47.7%), while among those above 40 of age, membraneous nephropathy was most common(42.1%). 5) The pathologic diagnoses of the secondary NS were hepatitis B virus associated GN (46.8%), lupus nephritis (39.5%), amyloidosis (5.9%), post-infectious GN (2.7%), Henoch-Schoenlein nephritis (2.7%). We had one each case of thrombotic thrombocytopenic purpura, Fabry's disease, mixed essential cryoglobulinemia, light chain disease, and Alport's syndrome. In conclusion, minimal change nephrotic syndrome was the most common disease among the primary NS and hepatitis B virus associated GN was the most common among the secondary NS.