Analysis Of The Prognostic Factors And The Characteristics Of TCM Syndrome In Allograft With IgA Nephropathy

[Objective] Firstly, we will explore the prognostic factors (including clinical factors and pathological factors) affecting long-term survival of renal allograft with IgA nephropathy; Secondly, analyze the relationship between the TCM Syndrome and clinical parameters.[Methods] Cases came from the kidney transplant recipients with biopsy-proved IgA nephropathy in Fuzhou General Hospital from June 2004 to December 2009.The TCM diagnosis was "Hematuria", "Low back pain","Edema ","Consumptive" or "Dysuria ".All patients'TCM syndrome and clinical common indicators were collected.Divided into graft loss group and functioning graft group, the difference between the two groups were analyzed.The difference of clinical parameters also be analyzed among the different syndrome groups.[Results] A total of 42 recipients met the inclusion criteria.The range of follow-up was 1-257 months after renal transplantation, the mean age at transplantation was 36.1±9.2 years (range,19-60 years), the mean age at biopsy was 40.6±9.3 years (range,24-65 years).The commen presentation was an abnormal urine examination(83.3%).Twenty five(59.5%) displayed microscopic hemeturia with proteinuria. The mean Renal Lesion Score was 11.6±6.2 (range,3-24). Sixteen (38.1%)Glomerular sclerosis>25%, nine(21.4%) with Crescent formation,one(2.4%) with fibrinoid necrosis, twenty six(61.9%)tubular atrophy>25%,twenty two(53.4%) interstitial fibrosis>25%,thirty three(81.0%) with small atherosclerosis. Seventeen lost their grafts at a median time of 65 months after renal transplantation (range,8-257months). Three deficient syndrome was the major syndrome(83.3%) rather than other two sthenia syndrome (16.7%). There's no significant difference among the Three deficient syndrome groups in sex, age, blood pressure, pulse, urine, creatinine, serum albumin, triglycerides and cholesterol.There was a highest incidence(100%) and a lowest level of Hemoglobin in Qi-Yin deficient syndrome than other tow deficient syndrome groups.[Conclusion] Firstly, graft loss associate with a high creatinine at the time of biopsy, a great a high Renal Lesion Score, a low glomerular filtration rate, a low serum total protein and albumin, glomerular sclerosis>25%,crescent formation, tubular atrophy>25%, interstitial fibrosis>25%; Secondly,the following factors have no significant relationship with the outcome of renals with IgA nephropathy:blood pressure,blood urea nitrogen,uric acid, hemoglobin, triglyceride, cholesterol, small atherosclerosis, a merger of the acute or chronic rejection or calcineurin inhibitor toxicity, etc; Thirdly, the 1-,5-,and 10-year graft survivals of allografts with IgA nephropathy compared with allografs without glomerular disease and grafts with other type of glomerular disease have no significant difference.Fourthly, Qi-Yin deficient syndrome have a highest incidence(100%) and a lowest level of Hemoglobin.There is a high proportion of graft loss and a poor prognosis in the patients with Qi-Yin deficient syndrome.