IgA肾病患者高尿酸血症患病率及其相关危险因素分析

Prevalence and risk factors of hyperuricemia in patients with IgA nephropathy

目的探讨IgA肾病患者高尿酸血症的患病率及其临床、病理危险因素。方法回顾性分析1996年1月至2012年12月于中山大学附属第一医院行。肾穿刺活检确诊为IgA肾病的2566例患者的临床及病理特征，行多因素Logistic回归分析IgA肾病患者高尿酸血症发生的影响因素。结果2566例IgA肾病患者中，高尿酸血症的患病率为36．6％，其中CKD1～5期各期患者高尿酸血症的患病率分别为16．2％、37．4％、66．4％、87．7％和76．4％。IgA肾病患者伴发高尿酸血症的相关危险因素包括：男性、CKD分期高、肾活检病理球性硬化比例高。肾功能正常（CKD1～2期）]gA肾病患者伴发高尿酸血症的相关危险因素包括：男性、CKD分期高、血胆固醇水平升高及肾活检病理球性硬化比例高。肾功能受损（CKD3—5期）IgA。肾病患者伴发高尿酸血症的相关危险因素包括：CKD分期高及肾活检病理球性硬化比例高。结论IgA肾病患者高尿酸血症的患病率为36．6％，明确IgA肾病肾功能正常及受损患者发生高尿酸血症的相关危险因素有利于本病的综合防治。

Objective To evaluate the prevalence of hyperuricemia in patients with IgA nephropathy and find out the risk factors of hyperuricemia, including clinical and pathological characteristics. Methods A retrospective study enrolled 2566 adult patients, who admitted to the First Affiliated Hospital, Sun Yat-sen University from 1996.01 to 2012.12 and diagnosed with biopsy- proven IgA nephropatby was conducted. Results Among 2566 IgA nepbropathy patients, the prevalence of hyperuricaemia was 36.6%. Prevalence of hyperuricaemia for CKD stage 1, 2, 3, 4, 5 was 16.2%, 37.4%, 66.4%, 87.7% and 76.4%, respectively. Adjusting Logistic regression analysis showed male gender, progressive stages of CKD, increased percentage of global glomerulosclerosis were independent risk factors of IgA nephropathy; male gender, progressive stage of CKD, increased level of cholesterol, increased percentage of global glomerulosclerosis were independent risk factors for CKD stage 1 -2 patients; progressive stages of CKD and increased percentage of global glomerulosclerosis were independent risk factors for CKD stage 3- 5 patients. Conclusion The prevalence of hyperuricemia in patients with IgA nephropathy was 36.6%, and identifying the risk factors associated with hyperuricaemia among different CKD stages of IgA nephropathy will be important to improve our understanding in intervention of this disease.