The Correlation Between Hyperuricaemia And The Clinic-pathological Of IgA Nephropathy

Background: IgA nephropathy is an idiopathic glomerulonephritis characterized by predominant IgA deposition in the mesangium. And it is the most common type of glomerulonephritis in our country. The clinical manifestation and renal pathology are diverse. And its pathogenesis in still unclear, so there is no effective treatment. Because of living standards was improved and the diet was changed, the incidence of hyperuricaemia increase significantly in IgA nephropathy, and the influence between uric acid and the clinic-pathological of IgA nephropathy taked more and more attention.Objective: To analyze the incidence of hyperuricaemia in IgA nephropathy, and to analyze the relevance between serum uric acid and the clinic biochemical parameters and renal histological grade of IgA nephropathy, to clarify the harm of hyperuricaemia in the development of IgA nephropathy and to provide an evidence for judging the disease synthetically, slowing down the progress of IgA nephropathy into end stage renal disease and guiding its treatment.Materials and Methods: A retrospective study of 122 cases of IgA nephropathy patients diagnosed by renal biopsy examination in our hospital from January 2007 to December 2009. These 122 patients were divided into hyperuricaemic patients and non hyperyricaemic patients according to the level of serum uric acid, to observe the clinical parameters and renal pathology grade in each group, including age, the disease duration, sex, blood pressure, liver function, kidney function, blood lipids, blood glucose, 24-hour urine protein amount, Lee's grade of pathological, TIL grade of tubulointerstitial damage and renal artery damage classification and so on. To analyze the relevance between serum uric acid and the clinic biochemical parameters and renal histological grade of IgA nephropathy. The measurement data was expressed as mean±standard deviation ( x±S), the different between groups was analysed by t-test, statistical analysis of count data was analysed byχ2 test. If P value <0.05, it was considered statistically significant.Results: (1) IgA nephropathy accounts for 32.7% of the primary glomerular disease which was diagnosed by renal biopsy in the sane term of our hospital. It is the common type of primary glomerular disease, 21~40 year-old age group made up of the most number of cases. (2) The incidence of hyperuricaemia was 25.4% in IgA nephropathy. (3) The incidence of hypertension and abnormal renal function was high in the group of hyperuricaemic patients, compared with normal serum uric acid was significant difference (P<0.05). (4) The disease duration, body mass index, blood urea nitrogen,serum creatinine, serum triglycerides, 24-hour urine protein amount were significant difference between the group of hyperuricemic patients and the group of normal serum uric acid patients (P<0.05). (5) The renal pathology Lee's grade IV + V was more than grade I,Ⅱin the group of hyperuricemic patients, but renal pathology Lee's IV + V grade was less than I grade,Ⅱgrade and III grade in the group of normal serum uric acid patients of IgA nephropathy. Grade IV + V compared with grade I+II had significant difference (P <0.01); (6) grade II of tubulointerstitial damage was common in the group of normal serum uric acid patients, while III+IV grade tubulointerstitial damage was common in the group of hyperuricemic patients. III+IV grade compared with I grade andⅡgrade had significant difference (P<0.01). (7) 3 grade of renal artery damage was more common than 0 grade in the group of hyperuricemic patients, while 3 grade of renal artery damage was less than 0 grade in the group of normal serum uric acid patients. The incidence of hyperuricaemia with 2 grade and 3 grade compared with 0 grade and 1 grade had significant difference (P<0.01).Conclusion: (1) IgA nephropathy is the most common type of primary glomerular diseases, and the incidence of hyperuricaemia was high in IgA nephropathy. (2) The level of serum uric acid is correlate with the duration of disease, body mass index, blood pressure, serum triglycerides and kidney function in IgA nephropathy. (3) The pathological damage was severe in the group of hyperuricaemic patients in IgA nephropathy, so we think the level of serum uric acid is an important indicator for poor prognosis. (4) We should pay more attention to the level of serum uric acid, and we should take some measures to lower the level of serum uric acid in order to improve long-term survival of kidney.