老年IgA肾病患者临床病理特点及预后分析

Clinicopathological features and prognosis of elderly patients with IgA nephropathy

目的:研究老年IgA肾病患者的临床、病理特点及其预后情况。方法:本研究为回顾性队列研究,分析中日友好医院近10年60岁以上的原发性IgA肾病患者的临床、病理及随访资料特点。结果:共纳入60例患者,平均年龄64.2±3.7岁。肾小管萎缩/间质纤维化与Cr、BUN呈显著正相关,与eGFR、HGB呈显著负相关;新月体形成与尿RBC呈显著正相关,与eGFR、HGB呈显著负相关。CKD 3-5期的老年IgA肾病患者较CKD 1-2期预后差。结论:肾小管萎缩/间质纤维化和新月体形成可加速老年IgA肾病患者疾病进展,肾活检时处于CKD3-5期是老年Ig A肾病患者进展至终末期肾脏病的独立危险因素。

Objective:To study the clinical,pathological characteristics and prognosis of elderly patients with I- gA nephropathy.Methods:A retrospective cohort study was conducted to analyze the clinical,pathological and follow-up characteristics of patients aged ≥60with primary IgA nephropathy in China-Japan Friendship in the past 10 years.Results:A total of 60 patients were enrolled,with an average age of 64.2±3.7years.Tubular atrophy/interstitial fibrosis were positively correlated with Cr and BUN,negatively correlated with eGFR and HGB. The formation of crescent was positively correlated with urinary RBC,negatively correlated with eGFR and HGB.Those in stages CKD 3-5 of elderly patients with IgA.nephropathy had poorer prognosis than those in stages CKD 1-2.Conclusion:Tubular atrophy/interstitial fibrosis and the formation of crescent can accelerate the progression of IgA nephropathy in elderly patients.Kidney function at CKD 3-5stages can significantly affect the progression to end-stage renal disease for the elderly patients with IgA nephropathy.