Correlated Study Of Hyperuricemia Between Clinical Pathological Features And Prognosis Of IgA Nephropathy

Purpose:Main purpose of this study is to analyze the correlation between uric acid and its clinical and pathological features of IgA nephropathy in our hospital using a retrospective cohort study.Furthermore,we would like to explore the influence of hyperuricemia on the progression and prognosis of IgA nephropathy and provide an important basis for the treatment of IgA nephropathy.Methods:Patient selection started from January 2011 to November 2017 in the Department of Nephrology from China-Japan Union Hospital.The retrospective cohort study was initiated by collecting the data of 79 patients who performed renal biopsy and where diagnosed with IgA nephropathy.The cohort group was subsequently divided into a Normal uric acid group and a hyperuricemia group on the basis of uric acid levels in the blood.The general attributes of patients including age and gender was recorded in the records.Those patients who performed a renal biopsy were monitored previous to the study,vitals including their height and weight,and disease duration.The patient’s blood pressures were also recorded periodically.The main feature of their serum indexes where noted including blood urea nitrogen,blood creatinine,blood uric acid,cystatin C,serum albumin,hemoglobin,erythrocyte sedimentation rate,triglyceride,total cholesterol,blood IgA,blood C3,blood C4;urine test including urine albumin,24 hours urine protein;pathologic indexes including IgA nephropathy followed by pathological grading(Lee grading),TIL grading and glomerular vascular injury where mainly used for classification,and empirical methods where used to analyze all the data statistically.Results:1.The patients with IgAN usually present at ages ranging from 21-30 years old,accounting for 37.97%of the total population.The age of patients presenting with hyperuricemia and IgAN is mainly concentrated at the 21-30 years old range,accounting for 16.46%of the total population.2.According to the data recorded in the study,there was no significant difference in the sex and age of the patients.This had no effect on the course of disease between the normal uric acid group as compared to the hyperuricemia group(Noted p>0.05).On the contrary,there was a significant difference in body mass index(BMI).This can be seen statistically between the two groups(p value<0.01).Therefore,we may conclude that the body mass index of patients in the hyperuricemia group was higher than that of the normal uric acid group participants.3.There was a statistical difference between the Normal uric acid group and the hyperuricemia group in the population proportion of hypertension(p<0.05),in conclusion,the percentage of hypertension in the hyperuricemia group is higher than the normal uric acid group.4.There was a statistical difference between Normal uric acid group and hyperuricemia group in the proportion of renal insufficiency,Blood Urea nitrogen and serum creatinine(p<0.01),in conclusion,the percentage of renal insufficiency in the hyperuricemia group is higher than the normal uric acid group.5.There was a significant difference between the normal uric acid group and the hyperuricemia group after testing serum triglyceride,CysC,24h urine protein and urine albumin have(p<0.05).We can conclude that the hyperuricemia group has a higher index than the normal uric acid group.Notably,as seen by the results,there was no significant difference in serum albumin,the level of blood cholesterol,both serum C3 and C4,and IgA,ESR between the two groups(p>0.05).6.There was significant difference in the ratio of Lee pathological grading between the normal uric acid group and the hyperuricemia group(P<0.05).The proportion of grade Ⅰ +Ⅱ,Ⅲ was higher in the normal uric acid group.The proportion of grade Ⅳ+Ⅴ was higher in the hyperuricemia group.There was a higher grading Ⅲ、Ⅳ+Ⅴ in the hyperuricemia group Ⅳ + Ⅳ ratio in comparison to the normal uric acid group significantly.7.While conducting the study,it was noted that there was a statistically significant difference featuring the TIL gradings between the hyperuricemia group and the normal group(p<0.01).The proportion of grading III +IV was higher in the hyperuricemia group.There was a higher TIL grading III + IV ratio in comparison to the normal uric acid group.There was a statistically significant difference in the ratio of different renal arterioles gradings between the hyperuricemia group and the normal group(p<0.01).The proportion of grade 0 was higher in the normal group,and the proportion of grade 3 in the group was higher in the hyperuricemia group.The proportion of grade 3 in the hyperuricemia group was higher than that in the normal group.Conclusion:1.The debilitating effects of IgA nephropathy can commonly be seen in young people,mostly males.Subsequently,IgA nephropathy with hyperuricemia frequently shows up at a high incidence rate(IR).2.Hyperuricemia in IgA nephropathy was closely related to many factors which must be taken into consideration,prioritizing BMI and blood pressure,triglyceride,urea nitrogen,creatinine,cystatin C,24-hour urinary protein and microalbumin must all be taken into account3.The levels of serum uric acid in IgA nephropathy was correlated with the Lee’s pathological grading,TIL grading and renal arteriole grading.The higher the uric acid is,the more serious the pathological grading is.It is a risk factor for disease progression and prognosis.4.Hyperuricemia in patients with IgA nephropathy should be controlled actively to delay the progress of the disease and to improve the long-term survival rate of patients with IgA nephropathy.