Clinical And Pathological Features Of Idiopathic Membranous Nephropathy Patients Combined With Hyperuricemia

Objective:The aim to obtain the circumstances of hyperuricemia(HUA)in patients with idio-pathic membranous nephropathy(IMN)and to explore the impact of hyperuricemia on the clinical and pathological features of idiopathic membranous nephropathy.So that we can comprehensively master the progression of IMN in clinical practice to a certain extent,which guide IMN's individual treatment options,judge the prognosis situation,thus to some extent can delay the progress of chronic kidney disease and provide the evi-dence.Method:Selection 100 patients with idiopathic membranous nephropathy in the Department of Nephrology of Affiliated Hospital of Yan,an University from January 2015 to November 2017.According to the standard of serum uric acid(male>420 mmol/L and female>360mmol/L),the 100 IMN patients were divided into two groups: group one :31patients with hyperuricemia;and another group:69 patients go with blood uric acid in normal standard.The characteristics of the clinical and pathological data of the two groups were analyzed and compared by statistical methods.SPSS22.0 statistical software(Chinese Version)was used to analyze the data of this study.First,we do general descriptive analysis.The statistical description of measure-ment data is expressed by(mean+standard deviation).Counting data is expressed by rate.Chi square test or chi square test and Fisher exact probability method are used for counting data analysis.Set the test level P to 0.05.When P is not exceed 0.05,the data is significant differences.Result:1.The 100 patients with IMN were selected in this research,31 patients with Hyperuricemia,another 69 patients were at normal level of serum uric acid standard,the preva-lence rate of hyperuricemia in patients with IMN was 31%.2.Among the 100 patients who compliance with IMN pathological character,63 were male(63%)and 37 were female(37%),and the average age were at(41.17+15.46).Judging from the perspective of sex,age,disease duration,and the edema of both lower extremities,there was no significant difference between IMN patients with hyperurice-mia and normal serum uric acid of IMN patients.However,there was significant difference between IMN patients with hyperuricemia and IMN patients with normal blood uric acid in sex,pathological diagnosis,blood pressure(the systolic blood pressure and the diastolic blood pressure),hematuria and renal insufficiency(P<0.05).3.Compared with IMN patients with normal level of uric acid,the IMN patients with hyperuricemia in 24h-Pr,TC,TG,Creatinine,Blood urea nitrogen,and Estimated glomerular filtration rate(estimated,glomerular filtrationrate,eGFR)were had a significant differences(P<0.05).White in the Blood leukocytes ? hemoglobin ? serum albumin(ALB)?ALT?AST?blood glucose??2-MG?Cys-c,no obvious difference between the two groups(P>0.05).4.Judging from the effect of hyperuricemia on IMN from the stage of chronic kidney disease(CKD),IMN patients with hyperuricemia primary distributed in CKD2 and CKD3-4,while another group mainly at the stage of CKD1,the difference between them were obvious(P is 0.003).Additionally compared from the aspect of Oxford classification(mesocytosis,glomerulosclerosis,tubulointerstitial fibrosis),IMN patients with hyperuricemia has severe kidney pathological injury than another one,and there was clear statistics meaning divergence among the two series(P<0.05).5.From the comparison of two groups of patients with basilar membrane injury: no obviously difference in the glomerular basement membrane staging among two groups,and all of them were mainly in phase II and III(P is 0.09).From the aspect of mesangialproliferation,the two groups were mainly have mild mesangial hyperplasia,and there was no obviously difference in thickening of arteriolar walls and hyaline degeneration of arteries(P>0.05).6.From the Electron microscope,IMN combined with hyperuricemia group has a higher proportion in mesangial zone dense deposits than the IMN patients with normal uric acid,and the difference was particularly,have statistics meaning(P is 0.03).From the immunoglobulin deposition of immunopathological,two groups were mainly consisted of IgG and complement C3.At the same time,a certain amount of immunoglobulin IgA,IgM and complement C1 q were observed.There was no statistics meaning divergence among the two series(P is 0.74).Conclusion:1.The prevalence of hyperuricemia in patients with IMN is higher,and in particu-larly,it is more likely to occur in men.2.IMN patients with hyperuricemia have higher 24h-Pr,blood lipid(TC,TG),creati-nine and urea nitrogen.Hyperuricemia can aggravate the speeding of renal function damage about the patients diagnosed as IMN.3.In the view of light microscopy and the type of immunofluorescence deposition about IMN patients,the role of hyperuricemia is not so obvious,but it is able to influence the dense deposits in mesangial region.4.Hyperuricemia may have a certain impact on the IMN patients in clinical and pathology,so for the patients who were diagnosed as IMN should pay attention to the management of uric acid,Take comprehensive and effective treatment measures should been taken,so that it can play an important role in delaying the progression of the disease in IMN patients.