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Main Pathological Types of Primary Nephrotic Syndrome


2012-10-31 19:42

Primary nephritic syndrome is caused by primary glomerulonephritis. It mainly includes three pathological types.

Minimal change disease

1. Minimal change disease is mainly seen in children, especially between ages 2~6. However, it is also commonly seen in the elderly.

2. In clinic, it often occurs after colds. The incidence of microscopic hematuria is low, only accounting for 15~20%. Gross hematuria rarely occurs. Meanwhile, high blood pressure and renal function decline usually do not occur.

3. Most patients with minimal change disease are sensitive to hormones. More than 90% of children with the condition and the 80~85% adults can have remission after treatment.

4. The condition is very likely to relapse and reoccurrence rate can reach 60%. If it relapses frequently, it may develop into focal segmental glomerulosclerosis (FSGS).

Membranous nephropathy

1. It mainly occurs in the elderly.

2. Membranous nephropathy usually occurs latently and it covers 80% cases of primary nephritic syndrome. About 40% of patients develop microscopic hematuria, but do not develop gross hematuria. In early stage, most patients do not develop high blood pressure. In 1/3 cases, the disease progresses slowly and may develop into renal insufficiency within 5~10 years.

Based on pathological changes, membranous nephropathy can be divided into four stages. In first stage, about half of the patients can have remission after using hormone. However, once it develops into stage 2, the patients usually do not have improvement after treatment.

FSGS

1. FSGS mainly occurs among adults.

2. It usually starts latently. Nephrotic syndrome can be seen in 50%~70% cases and the incidence of hematuria is very high. Also, gross hematuria is commonly seen in FSGS. Most of the patients are not sensitive to hormone and only the patients with mild condition can have improvement. Therefore, it is very important for the patients to seek for alternative treatment as early as possible.


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