| Objective:The general data,laboratory indicators and Oxford classification of pathological tissues of IgA nephropathy(IgAN)patients with hyperuricemia(HUA)were analyzed to explore the related risk factors of IgAN with hyperuricemia,providing a basis for diagnosis and treatment of the disease.Methods:A retrospective study was performed on 300 patients diagnosed with IgAN who were admitted to the Department of Nephrology of Shanxi Provincial People’s Hospital from January 1,2015 to August 31,2021.According to the level of serum uric acid tested on admission,they were divided into high uric acid group(n=130)and normal uric acid group(n=170).General data,laboratory indicators and pathological data were collected.Univariate statistics and analysis were performed on general data,laboratory indicators and Oxford pathological classification,and the significant indicators were included in multivariate Logistic regression analysis to further explore the risk factors related to IgAN HUA.Rank sum test was used to analyze the stage of chronic kidney disease(CKD)and the grading structure distribution of 24-hour urinary protein(24h-UP)in the two groups,and to explore the relationship between CKD stage and 24H-UP grading in IgAN patients with HUA.P<0.05 was statistically significant.Results:1.General data characteristics:there were no statistically significant differences in gender,age,smoking history,drinking history and diabetes incidence between the two groups.The incidence of hypertension and body mass index(BMI)in the high uric acid group were higher than those in the normal uric acid group,with statistically significant differences(P<0.05).2.Characteristics of laboratory indicators:there were no statistically significant differences in RBC,HGB,ALB and serum complement C1q between the two groups.Total cholesterol(CHO),triglyceride(TG),low-density lipoprotein(LDL),urea nitrogen(BUN),serum creatinine(Scr),cystatin(Cys-C)and 24H-UP in high uric acid group were significantly higher than those in normal uric acid group.The glomerular filtration rate(GFR)was significantly lower than that in normal uric acid group(P<0.05).3.Histopathologic classification comparison:Oxford mesangial cell hyperplasia(M)between the two groups,within the capillary hyperplasia(E),renal tubular atrophy/fibrosis(T),if there is a crescent formation(C)there was no statistically significant difference,high uric acid group of segmental glomerular sclerosis and adhesion(S)the incidence of higher than normal uric acid group(P<0.05).4.After univariate analysis,significant general data,laboratory indicators and Oxford pathological classification were included in the multivariate Logistic regression model.The results showed that TG was an independent risk factor for IgAN hyperuricemia,and the incidence of hyperuricemia increased by 28.2%with each increase of 1mmol/L TG.Increased GFR reduced the risk of hyperuricemia,and the incidence of hyperuricemia was decreased by 2.4%for every 1ml/min·1.73m~2GFR increase(P<0.05).5.Characteristics of CKD staging:the overall level of CKD staging was higher in the high uric acid group,and the incidence of hyperuricemia in CKD3-5 was significantly higher than that in CKD1-2,with statistical significance(P<0.05).6.Characteristics of 24-hour urine protein grading:the overall level of urine protein grading was higher in the high uric acid group,and the incidence of hyperuricemia in grade 3 was significantly higher than that in grade 1-2,with statistical significance(P<0.05).Conclusion:1.Compared with normal uric acid group,IgAN patients with HUA had higher BMI,higher incidence of hypertension and hyperlipidemia,higher BUN,Scr,CYS-C and24-UP indexes;GFR is low.2.IgAN segmental glomerulosclerosis and adhesion with hyperuricemia are more serious.3.Logistic multivariate regression analysis showed that TG was an independent risk factor for IgAN hyperuricemia,and high GFR reduces the risk of developing hyperuricemia.4.IgAN patients with hyperuricemia had higher CKD stage and 24-hour urinary protein grade. |
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