The Levels Of Serum Uric Acid And The Glomerular Ischemic In Patients With IgA Nephropathy

Objective:IgA nephropathy is the most common form of glomerulonephritis in the world,and is also the main cause of end stage renal disease.Current researches show thathyperuricemia is the independent risk factor of IgA nephropathy progression.Uric acid will affect the intrarenal artery lesions of IgA nephropathy. But the relationship between serum uric acid and glomerular ischemic lesion in IgA nephropathy is still uncertain. The subject of our research is to study theglomerular ischemic lesion in IgA nephropathy. The reason of hyperuricemia is uric acid production increased or excretion decreased, Uric acid excretion in IgA nephropathy patients with hyperuricemia is not clear, we will study theuric acid excretion in IgA nephropathy patients with hyperuricemia. Hyperuricemia is related withtheglomerular ischemic lesion in IgA nephropathy,uric acid excretion will be affected by theglomerular ischemic lesion is not clear. We will study the relationship between uric acid excretion and theglomerular ischemic lesion.Subjects and methods:Clinical data of 207 IgA nephropathy patients with normalrenal function were collected from November 2012 to 2015. Who were hospitalized in Tianjing Medical University General Hospital.According to the level of uric acid, patients were divided into two groups, one is the hyperuricemia group, the other is the normal uric acid group.The hyperuricemia group has 46 patients, the normal uric acid group has 161 patients. Compare the clinical data andglomerular ischemic lesionsin each two group.According to renal biopsy results,patients were divided into glomerular ischemic lesions group and non-ischemic glomerular lesions group. The glomerular ischemic lesions group has 90 patients, the non-ischemic glomerular lesions group has 117 patients.Compare the clinical data in each two group. Analysis the relationship between uric acid and glomerular ischemic lesions in IgA nephropathy. We choose 30 patients with hyperuricemia in IgA nephropathy from November 2014 to2015.Calulating the uric acid clearance, to analysis the uric acid excretion in IgAnephropathy patients with hyperuricemia.Then according to renal biopsy results,patients were divided into glomerular ischemic lesions group and non-ischemic glomerular lesions group. The glomerular ischemic lesions group has17 patients, the non-ischemic glomerular lesions group has 13 patients.Compare theuric acid clearance. Analysis the relationship between uric acid excretion and glomerular ischemic lesions in IgA nephropathy.Results:(1)Compared to normal uric acid group, the proportion of weight, systolic blood pressure, serum urea nitrogen, serum creatinine, triglycerides,24 h urinary protein in hyperuricemia group were higher.(p<0.05)(2)The incidence rate of glomerular ischemic lesion in IgAnephropathy with hyperuricemia(73.91%) is significantly higher than that of normal uric acid group(34.78%),( p=0.000).When uric acid is above 350umol/L, the incidence of glomerular ischemic lesions is significantly increased, and with the increase of serum uric acid level, the incidence of glomerular ischemic lesions has also increased,(?2=22.29,P=0.000)(3) The uric acid in IgA nephropathy with glomerular ischemic lesion is significantly higher than those without glomerular ischemic lesion(p<0.05). The Spearman correlation analysis showed that the urine uric acid level is positive correlation with the percentage of ischemic lesion of glomeruli, correlation index r=0.252,(P<0.05).Multiple logistic regression analyses revealed that the uric acid level were significantly associated with glomerular ischemic lesion(p < 0.05). After controlling forserum urea nitrogen and serum creatinine, compared with normal uric acid group,the hyperuricemia group exhibited a nearly 4.03-fold increase in the risk of glomerular ischemic lesion(p < 0.05)(4) 93.34% of hyperuricemia in patients with IgA nephropathy belongs to the poor excretion of uric acid.Significantly higher than that of mixed type(6.66%).(5)The uric acid clearance in IgA nephropathy without glomerular ischemic lesion is significantly higher than those with glomerular ischemic lesion(p<0.05); The uric acid excretion in IgA nephropathy without glomerular ischemic lesion is significantly higher than those with glomerular ischemic lesion(p<0.05).The Spearman correlationanalysis showed that the uric acid clearance is negative correlation with the percentage of ischemic lesion of glomeruli, correlation index r=-0.561,(P<0.05)The Spearman correlation analysis showed that the uric acid excretion is negative correlation with the percentage of ischemic lesion of glomeruli, correlation index r=-0.564,(P<0.05)Conclusion:(1) Uric acid is closely associated with glomerular ischemic lesion in IgA nephropathy. Our results suggest that Uric acid is an independent risk factor for glomerular ischemic lesion in IgAnephropathy.(2)The main reason of hyperuricemia in IgA nephropathy patients with normal renal function is the poor uric acid excretion.The poor uric acid excretion is related with glomerular ischemic lesion in IgAnephropathy.