Analysis Of Influencing Factors Of 360 Primary IgA Nephropathy With Renal Interstitial Fibrosis

Objective:To analyze the clinicopathological features,to explore the influencing factors of renal interstitial fibrosis in primary IgAN.Methods:360 patients who were diagnosed as IgAN by renal biopsy and admitted to the Fisrt Affiliated Hospital of Chongqing Medical University from January 2011 to December 2016 were enrolled.They were divided into TO group(without or mild renal interstitial fibrosis)and T1-2 group(moderate or severe renal interstitial fibrosis)according to the severity of renal interstitial fibrosis.The clinicopathological characteristics were retrospectively compared,logistic regression analysis was used to analyze influencing factors.Results:?Among the 360 patients,the ratio of male and female was 0.85:1,with a median age of 33(25,42)years old at biopsy,chronic nephritis syndrome(70.6%)and asymptomatic hematuria and(or)proteinuria(17.2%)were common clinical manifestations.?The TO group accounted for 73.1%and the T1-2 group accounted for 26.9%.There was no significant difference between the two groups in gender,age,albumin,total cholesterol,triglyceride,hemoglobin,glomerular mesangial cell hypercellularity(M)and crescent.Compared to TO group,T1-2 group exhibited more severe clinical manifestations including higher average arterial pressure,serum urea,serum creatinine,serum uric acid,urine protein quantification,and lower endogenous creatinine clearance rate(Ccr)(P<0.05,respectively).Besides,T1-2 group had worse histological lesions,including segmental glomerulosclerosis(S)(x2=22.298,P=0.000),endocapillary proliferation(E)(x2=8.682,P=0.003),renal artery lesions(A)(X2=16.935,P=0.000)and renal interstitial inflammation(x2=21.156,P=0.000).?The multivariate analysis suggested that serum creatinine,proteinuria,Ccr,S,A,and interstitial inflammation are independent factors for the renal interstitial fibrosis of IgAN.Conclusion:Renal interstitial fibrosis is a common pathological feature in IgA nephropathy,which is closely related to disease progression and prognosis.Serum creatinine,proteinuria,Ccr,S,A,and interstitial inflammation are independent factors for the renal interstitial fibrosis of IgAN.Clinically,we should actively reduce urinary protein,reduce uric acid,control blood pressure,improve renal vascular lesions,resist inflammation and inhibit immune and so on,and to delay the progression of renal interstitial fibrosis and improve the prognosis of IgAN.