IgA nephropathy Lee grading is mainly for the grading of the condition and symptoms of IgA nephropathy, which requires a kidney puncture examination to determine the grading, which is conducive to the prescription of the right medicine. 1.Grade I: The majority of glomeruli in this stage are normal, with occasional mild thylakoid widening (segmentation) with and/or without cellular hyperplasia, and no changes in tubules and interstitium, which is the mildest type of Lee’s classification. 2, Grade II: Patients in this stage show focal glomerular proliferation and sclerosis (<50%), with rare small crescentic bodies, and no tubular or interstitial damage. This stage is a more severe lesion compared to the first stage, with focal damage on light microscopy and lesions affecting a few glomeruli (focal) and some lobules (segments) of the glomerulus. < p="">Grade III: At this point, the patient’s glomeruli show diffuse thylakoidal accretion and widening (occasionally focal segments), with occasional small crescents; tubular and interstitial changes then show focal interstitial edema, with occasional cellular infiltration and rare tubular atrophy. Cellular infiltration can then lead to an inflammatory response, at which point, if not promptly arrested, the functional cells of the kidney will phenotypically transform during the inflammatory response and a series of nephrotoxic factors will be released. The area of glomerulosclerosis will increase, tubular atrophy will also increase, and interstitial renal vascular fibrosis will also occur. 4.Grade IV:The glomerular lesions show severe diffuse thylakoid hyperplasia and sclerosis, with partial or total glomerular sclerosis and visible crescentic bodies (<45%). Renal tubular atrophy, interstitial infiltration, and occasional interstitial foam cells were seen. In this type, for example, crescentic body is close to 50%, and it can be said that if patients do not pay attention to it, it is likely to reach this number, and research shows that when the crescentic body exceeds more than 50% of the total number of glomeruli, it is crescentic nephritis (or crescentic IGA nephropathy), which is the most common type II-immune complex crescentic nephritis in China in addition to lupus nephritis, and its severity speaks for itself. < p=""> Grade V:The nature of glomerular lesions is similar to grade IV but more severe, with glomerular crescent formation >45%; tubular and interstitial lesions are similar to grade IV but more severe. The lesions in this stage of IgA nephropathy are the most severe in IgA nephropathy, so it is also the most difficult to treat, and IgA nephropathy treatment measures are no different from grade IV treatment, except that a more stringent treatment plan is required, and perhaps the duration of treatment will be relatively longer. Clinical manifestations and pathological links: 1) recurrent botrythematous hematuria (30-40%) 1) occurs a few hours to 1-2 days after upper respiratory tract infection (gastrointestinal or urinary tract infection); 2) mostly without concomitant symptoms, a few have urinary discomfort and are diagnosed as acute cystitis; 3) botrythematuria is more common in children and adolescents (80-90%) than in adults (30-40%); 4) is not related to disease severity 5) renal pathology is generally Lee’s grade II-III. 2. Occult nephritis (20-30%) 1) microscopic hematuria, 25% with intermittent episodes of carnituria; 2) with or without proteinuria (+); 3) a few have hypertension; 4) renal pathology is generally Lee’s grade II-III. 3, chronic nephritis type 1) microscopic hematuria with or without proteinuria (+-++); 2) often with hypertension; 3) renal function may have decreased; 4) renal pathology is generally Lee’s grade II-IV. 4, massive proteinuria or nephrotic syndrome type 1) nephrotic syndrome, with or without microscopic hematuria; 2) more hypertension; 3) some patients show nephrotic syndrome, renal light microscopy can be: microscopic lesions and mild diffuse proliferative glomerulonephritis; 4) renal pathology is generally Lee’s grade Ⅰ to Ⅳ. 5, malignant hypertension type 1) malignant hypertension; 2) proteinuria (+-++) with or without microscopic hematuria; 3) often combined with renal insufficiency; 4) renal pathology is generally Lee’s grade III-IV. 6. Acute nephritis syndrome type 1) progressive deterioration of renal function with progressive oliguria; 2) proteinuria (+-++) with or without microscopic hematuria; 3) hypertension and anemia; 4) renal pathology is usually crescentic nephritis, Lee’s grade IV~V.