Analysis Of Clinical And Pathological Characteristics Of Patients With Lupus Nephritis With Hyperuricemia

Objective:To analyze the clinical and pathological characteristics of lupus nephritis(LN)patients with hyperuricemia,and to explore the risk factors for renal dysfunction in LN patients.Methods:Clinical and pathological data collected from 86 patients with SLE complicated with LN,who were hospitalized in Fujian Medical University Union Hospital Nephrology Department from June 2014 to June 2019,were retrospectively analyzed.According to the serum uric acid level,they were divided into hyperuricemia group and non-hyperuricemia group.The clinical,laboratory,and pathological data of the two groups were compared.Results:86 LN patients,where patients with hyperuricemia accounted for 59.30%(51/86),were divided into hyperuricemia group(HUA group)(51 cases)and non-hyperuricemia group(non-HUA group)(35 cases).The serum uric acid level of LN patients was positively correlated with BMI,SBP,DBP,MAP,urine red blood cell count,24-hour urine protein quantification,TC,TG,LDL-C,inorganic phosphate,BUN,SCr,and SLE disease activity index(SLEDAI)(all P<0.05).There was a negatively correlation with Hb,total serum protein,serum albumin,HDL-C,eGFR,and C3(all P<0.05),but no significantly correlation with age,the length of the disease,WBC,PLT,glucose,IgG,IgM,IgA,and C4(P>0.05).Multivariate logistic regression analysis showed that Hb and serum uric acid were independent risk factors for renal dysfunction in patients with LN.The pathological type of 50 cases LN patients lacked type Ⅰ and type Ⅱ.The most common pathological type was type Ⅳ+Ⅴ(19 cases(38.00%)),followed by type Ⅳ(13 cases(26.00%)),type Ⅴ(9 cases(18.00%)),type Ⅲ+Ⅴ(7 cases(14.00%)),typeⅢ(1 case(2.00%))and type Ⅵ(1 case(2.00%)).Among them,30 cases were in the hyperuricemia group and 20 cases were in the non-hyperuricemia group.There were significant differences in the degree of glomerular sclerosis and the type of crescents between two groups(all P<0.05),and there were no significant differences in pathological type,AI score,CI score,glomerular sclerosis formation ratio,spherical sclerosis formation ratio,segmental sclerosis formation ratio and crescents formation ratio(all P>0.05).ROC curve of SUA was drawed to predict LN patients’ renal dysfunction,and the area under the curve was 0.707±0.057(95%CI:0.594-0.819,P=0.001).When uric acid level of 518.5mmol/L was used to predict renal dysfunction in LN patients,the sensitivity was 0.412,and the specificity was 0.904.Conclusions:(1)LN patients had a higher prevalence of HUA(59.30%).(2)LN patients with HUA had more severe clinical and pathological damage.Increasing serum uric acid level was closely related to hypertension,dyslipidemia,anemia,decreased renal function,and disease activity in LN patients.LN patients with HUA had more severe glomerular sclerosis.(3)Multivariate Logistic regression analysis showed that Hb and serum uric acid were independent risk factors for renal dysfunction in LN patients.