原发性IgA肾病合并高尿酸血症的临床病理特点及与不良肾脏结局的相关分析

Clinicopathological features of primary IgA nephropathy with hyperuricemia and its correlation with adverse renal outcomes

目的:探讨原发性IgA肾病合并高尿酸血症的临床病理特点及与不良肾脏结局的相关性。方法:选取110例原发性IgA肾病患者为研究对象,根据血尿酸(SUA)水平不同分为研究组(合并高尿酸血症,n=42)和对照组(SUA水平正常,n=68)。比较两组患者临床病理资料,分析其与不良肾脏结局的相关性。结果:研究组患者男性占比、高血压发病率、尿素氮、24 h尿蛋白、血肌酐(Scr)、胱抑素C(Cys-C)、三酰甘油(TG)水平高于对照组(P<0.05);肾小球滤过率(eGFR)低于对照组(P<0.05);肾小管萎缩或间质纤维化的病变程度、不良肾脏结局发生率高于对照组(P<0.05);多因素回归分析显示,高尿酸血症是原发性IgA肾病患者不良肾脏结局的独立危险因素(P<0.05)。结论:与血尿酸正常者比较,原发性IgA肾病合并高尿酸血症患者的临床表现更突出,肾脏病理损伤更严重,高尿酸血症会增加不良肾脏结局的风险。

Objective:To investigate the clinicopathological features of primary IgA nephropathy with hyperuricemia and its correlation with adverse renal outcomes.Methods:110 patients with primary IgA nephropathy were selected as the research objects.According to the level of serum uric acid(SUA),they were divided into study group(42 cases with hyperuricemia)and control group(68 cases with normal SUA).The clinicopathological data and adverse renal outcomes of the two groups were compared and analyzed.Results:The proportion of male,incidence rate of hypertension,urea nitrogen,and 24 The levels of h-urine protein,SCR,Cys-C and TG in the study group were higher than those in the control group(P<0.05),the eGFR was lower than that in the control group(P<0.05).The degree of renal tubular atrophy or interstitial fibrosis and the incidence of adverse renal outcomes in the study group was higher than that in the control group(P<0.05).Multivariate regression analysis showed that hyperuricemia was an independent risk factor for adverse renal outcomes in patients with primary IgA nephropathy(P<0.05).Conclusion:Compared with patients with normal serum uric acid,the clinical manifestations of patients with rimary IgA nephropathy comlicated with phyeruricemia are more prominent,and the renal pathological damage is more serious.Hyperuricemia will increase the risk of adverse renal outcomes.