The Change And Clinical Significance Of The Serum Uric Acid Levels In Patients With Lupus Nephritis

ObjectiveTo investigate the relationship between serum uric acid level and the severity of renal injury and its prognosis by retrospectively analyzing the clinical features,laboratory parameters and renal pathology in 110 patients with lupus nephritis?LN?.Patients and methods1.PatientsA retrospective analysis of the data of 110 cases for nephrology renal biopsy and diagnosis of LN patients was made in the First Affiliated Hospital of Medical University Of Anhui from January July 2015 to July 2017.The patients were divided into the two groups:LN patients with or without hypemricemia.2.methods?1?All patients were collected for clinical pathological indicators,including age,gender,serum creatinine,urea nitrogen,serum uric acid,complement C3,complement C4,immunoglobulin A,immunoglobulin M,immunoglobulin G,24-h urine protein,anti-double-stranded DNA,-Smith,-SSA,-SSB,-RNP antibodies.Glomerular filtration rate and systemic lupus erythematosus disease activity index score were calculated according to the formula.?2?Percutaneous renal biopsy was performed on all patients undergoing B-ultrasound localization.Nephrotic pathologic classification was performed using the LN pathological typing criteria established by the International Society of Nephrology and Nephrology Society?ISN/RPS?in 2003 and was assessed by activity index?AI?and Chronic index?CI?of renal pathological score;?3?To compare the clinical characteristics of the two groups,laboratory indicators and the differences between the kidney pathology.?4?All data were analyzed by SPSS 17 statistical software.Normal distribution measurement data were described in?x±s?,t test method,Pearson correlation analysiswas used to analyze data.Data which was not in conformity with the normal distribution was described in[M(P₂₅,P₇₅)],Mann-Whitney U test,Spearman analysis was used to analyzedata;Count data was expressed in frequency or rate?%?,the rate of comparison using chi-square test,P<0.05 for the difference was statistically significant.P<0.05 was considered as statistically significant.Results?1?Clinical data of two groups of patients:The clinical indicators,including the incidence rate of hypertension,level of blood serum creatinine,urea nitrogenin and 24-h urine protein in the LN patients with hyperuricemia group were higher than that in normal uric acid group,and estimate glomerular filtration rate was lower than that in normal uric acid group,the difference was statistically significant?P<0.05?.However,there was no significant difference between the two groups in the other factors such as age,sex,complement C3,complement C4,immunoglobulin A,immunoglobulin M,immunoglobulin G,systemic lupus erythematosus disease activity index score and Positive rate of anti-double-stranded DNA,-Smith,-SSA,-SSB,-RNP antibodies?P>0.05?.?2?Pathological classification of the two groups of patients compared:hyperuricemia group of LN patients with higher pathological classification level,the difference was statistically significant?Z=-2.865,P<0.01?.?3?Comparison of pathological score of two groups:Compared with normal uric acid group,patients with hyperuricemia group had higher activity index?t=-2.026,P=0.045?and chronic injury index?t=-4.547,P=0.000?than those with normal uric acid group,the difference was statistically significant.?4?LN patients with serum uric acid levels and renal damage indicators correlation analysis:Serum uric acid levels in patients with LN were positively correlated with serum creatinine?r=0.677,P=0.000?,urea nitrogen?r=0.572,P=0.000?,24-h urine protein?r=0.208,P=0.029?,pathological type of kidney?r=0.386,P=0.000?,AI score?r=0.292,P=0.002?and CI score?r=0.548,P=0.000?,but negatively correlated with estimated glomerular filtration rate?r=0.563,P=0.000?.ConclusionLN patients with hyperuricemia had more severe renal damagethan those in normaluric acid.Hyperuricemia is an important indicator for poor prognosis in patients withLN.