Analysis Of Clinical And Pathological Characteristics Of Hyperuricemia In Patients With IgA Nephropathy

Objective:To investigate the clinical and pathological characteristics of hyperuricemia in patients with IgA nephropathy(IgAN),and analyze the risk factors that affect the occurrence of hyperuricemia in patients with IgAN.Methods:The collection of cases with IgA nephropathy(IgAN)by renal biopsy in the nephrology department of First Hospital of Jilin University from January 2015 to August 2019.The patients were divided into normal uric acid groups(n = 123 cases)and hyperuricemia group(n = 179 cases).SPSS22.0 statistical software was used to analyze the clinical and pathological datas between the two groups of patients,and Logistic multivariate regression analysis was performed to analyze the independent risk factors of hyperuricemia in IgAN patients.Results:1.There were 123 patients of the 302 patients with primary IgAN in the normal uric acid group,accounting for 40.73% of the IgAN patients,of which 60 patiens were males,accounting for 48.80%,and 179 patiens were in the hyperuricemia group,accounting for 59.27% of IgAN patients,of which 109 patiens were males,accounting for 60.90%;the age of the patients between the two groups was not statistically significant.The proportion of males,bodymass index(BMI),incidence of hypertension,and mean arterial pressure in the hyperuricemia group were higher than those in the normal uric acid group,and the differences were statistically significant(P<0.05).2.Patients in the hyperuricemia group had higher white blood cell(WBC)counts,blood triglycerides,and 24-hour urine protein than those in the normal blood uric acid group(P <0.05);aspartate aminotransferase(AST)and high density lipoprotein(HDL)in the hyperuricemia group were lower than those in the normal uric acid group(P <0.05);serum creatinine,blood urea nitrogen,and cystatin C were significantly higher in the high uric acid group than those in the normal uric acid group(P <0.01),and estimated glomerular filtration rate(eGFR)was significantly lower than those in the normal uric acid group(P <0.01).3.According to the eGFR level,the chronic kidney disease(CKD)stage comparison was performed between the two groups of patients.In the normal uric acid group,72 patients(58.50%)were mainly in CKD1,105 patients(85.30%)were in CKD1 to CKD2,and 18 patients were in CKD3 to CKD5(14.70%);In the hyperuricemia group,59 patients(33.00%)were predominant,93 patients(52.00%)in the CKD1 to CKD2 stage,and 86 patients(48.00%)in the CKD3 to CKD5 stage;CKD1,CKD1 to CKD 2 in patients with the high uric acid group were significantly less than those in the normal uric acid group(P <0.01).CKD3,CKD4,CKD5,and CKD3 to CKD5 were significantly more than those in the normal uric acid group(P <0.01).4.The Lee's classification was used to compare the pathological results of the two groups.The normal uric acid group was mainly composed of 76 cases of grade III(61.80%),98 cases of grade?+?+?(79.70%)and 25 cases of grade?+?(20.30%);In the hyperuricemia group,81 cases(45.30%)were grade IV,83 cases(46.30%)were grade?+?+?,and 96 cases(53.70%)were grade?+?;Grades ?,?,? + ? + ? in patients with high uric acid group were significantly less than patients with normal uric acid(P <0.01),but grades?,? + ? were significantly more than those in the normal uric acid group(P <0.01).5.Katafuchi semi-quantitative score comparison was performed between the two groups of patients.The glomerular segmental damage,renal interstitial cell infiltration,and renal vascular disease in the hyperuricemia group were more severe than those in the normal uric acid group(P<0.05),the degree of sclerosis,renal interstitial fibrosis,and renal tubular atrophy were significantly more severe(P<0.01).6.By Logistic multivariate regression analysis,BMI(OR = 1.129,95% CI1.046-1.217)?BUN(OR = 1.246,95% CI1.045-1.487)?renal interstitial fibrosis(OR = 1.989,95% CI1.169-3.386)are independent risk factors for IgAN.Conclusion:1.In this study,the proportion of patients with IgAN combined with hyperuricemia is higher,and mainly males.2.Patients with IgAN combined with hyperuricemia have a large BMI,high incidence of hypertension and high mean arterial pressure,poor renal function,severe lipid metabolism disorders,and a high 24-hour urinary protein.3.Renal pathological damage is more severe in patients with IgAN combined with hyperuricemia.4.Logistic multivariate regression analysis shows that BMI,blood urea nitrogen and renal interstitial fibrosis were independent risk factors for hyperuricemia in IgAN.