Relationship Between Renal Vascular Lesions And Clinical-pathological Features In Patients With IgA Nephropathy

Objective: To analyse the clinical-pathological features of IgA nephropathy with renal vascular lesions,researched the clinical significance of renal vascular lesions.Methods: 182 patients with primary IgA nephropathy were enrolled in this study. According to histological characteristics by light microscope,the patients were divided into two groups:no renal vascular lesion and renal vascular lesion with hyalinosis, hyaline degeneration or thickening of blood vessels. Glomerular lesions and tubulointerstitial lesions were semi-quantitatively scored. The clinical-pathological features were compared between two groups,and then researched correlative factors by using step-wise multiple variance regression analysis.Results: 63 patients(34.6%) had renal vascular lesions.Significant differences between group A and group B were found in age,course of the disease,BMI,blood pressure,serum creatinine,GFR,cholesterol and triglyceride(p<0.05).The glomerular scores and the tubulointerstitial scores were higher in group B than that in group A(p<0.05),except the score of common depositon with IgA,IgG and IgM.The multiple variance regression analysis showed that cholesterol,global/segmental sclerosis,interstitial inflammation and diastolic pressure were the independent influencing factors of renal vascular lesion ( OR=2.381,1.405,2.873,3.066,P <0.001),and that renal vascular lesion was the independent influencing factor of GFR<90ml/min/1.73m2(OR=2.169,P<0.001).Conclusions: The clinical-pathological features of IgA nephropathy with renal vascular lesions were more severe than that without renal vascular lesions. Cholesterol,global/segmental sclerosis,interstitial inflammation and diastolic pressure were significantly associated with renal vascular lesions,and that renal vascular lesion was the influencing factor of the decrease of renal function.The common deposition of IgA,IgG and IgM may be protective factor of IgA nephropathy.