| Objective:To compare and investigate the relationship between serum uric acid and renal function in patients with IgA nephropathy and lupus nephritis.Methods:From January 1,2010 to September 30,2019,658 patients with IgA nephropathy,and 112 patients with lupus nephritis in our hospital were enrolled and divided into IgAN group and LN group.Univariate and multivariate linear regression analysis were used to analyze whether serum uric acid was independently related to e GFR.Interaction was used to stratification analysis to assess whether the correlation between serum uric acid and e GFR was statistically different between the two groups.Smooth curve fitting was used to detect whether there was a curve relationship between serum uric acid and e GFR.The above cases followed up until December 31,2019,and end point of the follow-up event was doubling of basic serum creatinine or ESRD.419 patients in the IgAN group and 94 in the LN group were enrolled to follow-up data analysis.Kaplan-Meier survival curve and COX regression analysis to assess the relationship between serum uric acid and renal prognosis.Interaction was used to stratification analysis to assess whether the relationship between serum uric acid and renal prognosis was different between the two group.smooth curve fitting to detect whether there was a curve relationship between serum uric acid and renal prognosis.Results : IgAN group with hyperuricemia accounted for 41.5%,and LN group with hyperuricemia accounted for 37.5%.Correlation analysis suggested that serum uric acid and e GFR were negatively correlated in two groups.Univariate and multivariate linear regression analysis indicated that serum uric acid was an independent negative factor of e GFR.The interaction in stratification analysis showed the relationship between serum uric acid and e GFR was not statistically different in the IgAN group and LN group.Smooth curve fitting suggests that the serum uric acid and e GFR in two groups had a linear relationship.The follow-up time was 3-102 months,419 cases in the IgAN group,the median follow-up time was 34.6 months,34(8.1%)reached the end point.94 cases in the LN group,the median follow-up time was 41.5 months,13(13.8%)Case reached the end point.Kaplan-Meier survival curve analysis found that the serum uric acid in the IgAN group that the renal prognosis was poor in the high serum uric acid group.The LN group found that the higher the serum uric acid level,the worse the renal function prognosis.Univariate and multivariate COX regression analysis results suggested that serum uric acid was an important risk factor for renal prognosis.The interaction in stratification analysis showed that there was no significant difference between serum uric acid and renal prognosis between the two groups.smooth curve fitting suggested that the relationship in serum uric acid and renal prognosis was U-shaped in the IgAN group,threshold and saturation effect analysis suggested that when the serum uric acid in IgAN patients is more than 320 umol / L,the higher the serum uric acid,the worse the renal prognosis;When serum uric acid was less than 320 umol / L,serum uric acid had no significant correlation with renal prognosis.Serum uric acid in the LN group has a saturation effect with renal prognosis,the threshold and saturation effect analysissuggested that when the serum uric acid in LN patients was less than 456 umol / L,the renal prognosis was worse as the serum uric acid increasing,while the serum uric acid was more than 320umol/L,the renal prognosis is no longer worse with increased serum uric acid.Conclusion:(1)Serum uric acid was independently negatively related with e GFR.The relationship between baseline serum uric acid and e GFR was not statistically different in patients with IgA nephropathy and lupus nephritis.(2)Elevated serum uric acid was an important risk factor for poor renal prognosis.The effect of serum uric acid on renal prognosis was not statistically different in patients with IgA nephropathy and lupus nephritis.(3)Serum uric acid in patients with IgA nephropathy had a U-shaped relationship with renal prognosis.Serum uric acid was more than 320umol/L is an important risk factor for poor renal prognosis.(4)The serum uric acid and renal prognosis of LN patients had a saturating effect.When the serum uric acid was less than456 umol / L,renal prognosis was worse with increased serum uric acid.when the serum uric acid was more than 456 umol / L,the renal prognosis was no longer worse with serum uric acid increased. |
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