Clinical And Pathological Analysis Of Primary IgA Nephropathy With Hyperuricemia

Objective To explore the cause and harm of hyperuricemia in primary IgA nephropathy through analyzing the clinical and pathological indicators.To provide an evidence for delaying the disease progression and to guide its treatment.Methods All the 64 inpatients,diagnosed with primary IgA nephropathy by renal biopsies,came from the Nephrology Department of the First Affiliated Hospital of Bengbu Medical College.According to the level of serum uric acid,these patients were divided into hyperuricemia group and nonhyperuricemia group.Observed indexes included gender,age,course of disease,blood pressure,serum uric acid,serum creatinine,blood urea nitrogen,plasma albumin,triglyceride,cholesterol,24 hour urinary protein and renal pathology of Lee's classification.The data were analyzed statistically.Results1.In this study,64 patients with primary IgA nephropathy accounted for 31.4% of the total numbers of renal biopsies.The incidence of hyperuricemia in primary IgA nephropathy was 35.9%.2.There are 4 cases with normal renal function and 19 cases with abnormal renal function in the hyperuricemia group,while 26 cases with normal renal function and 15 cases with abnormal renal function in the nonhyperuricemia group.The difference of the proportion of patients with abnormal renal function and normal renal function was statistically significant between the two groups(P<0.05).3.Age,course of disease,cholesterol,triglyceride and plasma albumin had no statistic difference between the hyperuricemia group and the nonhyperuricemia group(P>0.05).Serum creatinine,blood urea nitrogen,24 hour urinary protein and blood pressure showed statistically difference between the two groups(P<0.05).4.The proportions of hyperuricemia in Lee's Grade II,Grade III and Grade IV were6.7%,44.4%,46.2%,respectively.And there were statistical differences of the proportions among Lee's Grade II,Grade III and Grade IV in the patients with IgAnephropathy(P<0.05).5.By Spearman analysis,serum uric acid had no correlation with age,course of disease,cholesterol,triglyceride and plasma albumin in the patients with IgA nephropathy.Serum uric acid was positively correlated with blood urea nitrogen,24 hour urinary protein,and renal pathology of Lee's Grade.Serum uric acid was negatively correlated with eGFR.eGFR was negatively correlated with Lee's Grade.Blood urea nitrogen and24 hour urinary protein were positively correlated with Lee's Grade.6.Multivariate logistic regression analysis showed that male,age and hyperuricemia were risk factors for renal insufficiency in patients with primary IgA nephropathy.Conclusions1.The proportion of patients with primary IgA nephropathy complicated with hyperuricemia is higher than other pathological types.2.Serum uric acid is positively correlated with blood urea nitrogen,24 hour urinary protein,and renal pathology of Lee's Grade in patients with primary IgA nephropathy.And the more urine protein excrete,the more serious pathological damage of kidney is.These indicators shoud be monitored on time so that clinicians can know weather the disease progresses in time.3.Hyperuricemia is a significant risk factor for primary IgA nephropathy.Strengthening publicity and education and controlling the level of serum uric acid to patients with primary IgA nephropathy by clinicians have some guiding significance for the treatment and delaying its progress.