Clinical features of thin basement membrane disease and associated glomerulopathies.

Abstract

Thin basement membrane disease (TBMD) occurs in 5-11% of renal biopsy series, and can be associated with other glomerulopathies (GNs). Data on the prevalence, clinical features, and prognosis of TBMD with other GNs are limited. From June 1990 to May 2001, findings from 658 native kidney biopsies were retrospectively studied. The overall prevalence of TBMD was 7.9% (52 of 658). The mean glomerular basement membrane (GBM) thickness was 206 +/- 30 nm. Clinicopathological features were compared for patients with TBMD only (n = 14) and in those with TBMD and GN (n = 38). Focal segmental glomerulosclerosis, mesangial proliferative GN, and minimal change disease were the most common GNs associated with TBMD. After a mean follow-up period of 44.9 +/- 42.5 months, the group who only had TBMD revealed a relatively benign disease with microscopic haematuria and trivial proteinuria, a low prevalence of hypertension, and no renal progression. In the group who had both TBMD and GN, heavy proteinuria (6.1 +/- 5.2 g/day), hypoalbuminaemia (26 +/- 12 g/L) and renal insufficiency (76 +/- 25 mL/min) might develop. We suggested that the TBMD is a developmental abnormality of little or no significance and that it is the underlying associated GN rather than TBMD, which has the relevance to the outcome of renal disease.