Honkanen E
Clin Nephrol. 1986 Mar;25(3):122-8.
Sixty-seven patients with idiopathic membranous glomerulonephritis (iMGN) were analyzed clinically. Their mean age was 39.3 years, and 47 (70%) of them were male. Fifty (74.6%) showed nephrotic syndrome (NS) initially and five (7.5%) had additionally chronic renal failure. Hypertension was present in 27%. During the follow-up (mean 6.7 years) renal death occurred in four patients 12-151 (mean 84.2) months after the diagnosis of iMGN. Four patients died of non-renal causes. The actuarial life-table survival at 5, 10 and 15 years was 94%, 83% and 69%, respectively. To some extent renal function deteriorated in 13 patients (19%). These patients were older (49.9 vs. 36.8 years, p less than 0.01) than those with preserved renal function, and many of them had serum creatinine levels of 125 mumol/l or more initially. Sex did not correlate with the development of renal insufficiency. Patients with slight proteinuria never showed loss of renal function. The retrospective comparison of survival in patients who did (N = 31) or did not (N = 19) receive corticosteroids and/or immunosuppressive drugs for the treatment of NS revealed no evident difference at 5 or 10 years. This clinical analysis emphasizes the fairly favorable outcome of patients with iMGN. Hence a reserved view must be taken when treatment with potentially dangerous agents is considered in a disease with unknown etiology and pathogenesis.
对67例特发性膜性肾小球肾炎（iMGN）患者进行了临床分析。他们的平均年龄为39.3岁，其中47例（70%）为男性。50例（74.6%）最初表现为肾病综合征（NS），5例（7.5%）还伴有慢性肾衰竭。27%的患者存在高血压。在随访期间（平均6.7年），4例患者在诊断为iMGN后12 - 151（平均84.2）个月出现肾衰竭死亡。4例患者死于非肾性原因。5年、10年和15年的精算生命表生存率分别为94%、83%和69%。13例患者（19%）的肾功能在一定程度上有所恶化。这些患者比肾功能未恶化的患者年龄更大（49.9岁对36.8岁，p < 0.01），并且他们中的许多人最初血清肌酐水平达到或超过125μmol/l。性别与肾功能不全的发生无关。轻度蛋白尿患者从未出现肾功能丧失。对接受（N = 31）或未接受（N = 19）糖皮质激素和/或免疫抑制药物治疗NS的患者的生存情况进行回顾性比较，发现在5年或10年时没有明显差异。这项临床分析强调了iMGN患者相当良好的预后。因此，在一种病因和发病机制不明的疾病中考虑使用潜在危险药物进行治疗时，必须持谨慎态度。
