[Clinico-pathological study of focal glomerular sclerotic lesions in idiopathic membranous nephropathy].

Sixty-one patients with idiopathic membranous nephropathy (MN) were studied clinicopathologically to determine the significance of focal glomerular sclerotic lesions (FGSL). Renal biopsy specimens were examined by light and immunofluorescence microscopy. The light microscopic specimens were cut into 20 serial sections and odd-numbered ones were stained with Masson trichrome staining. The histopathological findings were scored and statistically analyzed. The patients were divided into two groups: Group I consisted of 15 MN patients with FGSL; the other 46 MN patients without FGSL composed Group II. Group I showed higher systolic blood pressure (p less than 0.01), longer duration of proteinuria (0.05), and higher levels of serum creatinine (p less than 0.001) than Group II. In Group I, the stage of membranous lesions was more advanced (p less than 0.01), and tubular atrophy, interstitial fibrosis and arteriolosclerosis were more severe than in Group II (p less than 0.05). The above results suggest that FGSL in MN may be related to the impairment of the renal function, but an only explanation for the cause of FGSL by the glomerular hyperfiltration theory is unlikely. Further investigations are required to clarify the full pathogenesis of FGSL.