Clinical and prognostic implications of serum uric acid levels on IgA nephropathy: a cohort study of 348 cases with a mean 5-year follow-up
Clinical and prognostic implications of serum uric acid levels on IgA nephropathy: a cohort study of 348 cases with a mean 5-year follow-up
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DOI：
10.5414/cn107813
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发表时间：
2013-07-01
影响因子：
1.1
通讯作者：
Liu, Zhang-suo
中科院分区：
文献类型：
--
作者：
Cheng, Gen-yang;Liu, Dong-wei;Liu, Zhang-suo
目的：通过长达8年的纵向随访研究，评价血尿酸水平对IgA肾病患者预后的影响，并探讨血尿酸水平与IgA肾病临床和病理表型的关系。对象和方法：我们回顾了2001-2009年间在本院接受治疗的所有连续的IgA肾病患者的资料。分析血清尿酸水平与IgA肾病临床和病理表型的关系。根据随访数据评估预后。结果：在相同的肾小球滤过率(GFR)下，不同血尿酸水平的两组患者24小时尿蛋白定量、血尿素氮(BUN)、血肌酐水平差异无统计学意义(p>；0.05)。血尿酸水平高的患者与血尿酸水平正常的患者相比，肾小球硬化的患病率以及肾小管间质和血管损伤评分更高(p<；0.05)。在随访期结束时，血尿酸水平高的患者肾小球滤过率降低和终末期肾病(ESRD)的发生率高于血尿酸水平正常的患者(分别为40.82比15.70%和64.71比35.00%；p<；0.05)。结论：IgA肾病患者血尿酸水平影响其病理生理及预后。我们还确定了高尿酸血症与较高的肾脏终点风险之间的相关性。
Aim: To assess the prognostic implications of serum uric acid levels on patients with IgA nephropathy in a longitudinal 8-year follow-up study and to identify an association between serum uric acid levels and the clinical and pathological phenotypes of IgA nephropathy. Subjects and methods: We reviewed the files of all consecutive patients with IgA nephropathy treated at our hospital between 2001 and 2009. Analyses were performed to investigate the association between the level of serum uric acid and both clinical and pathological phenotypes of IgA nephropathy. Prognosis was assessed based on follow-up data. Results: At the same glomerular filtration rate (GFR), there was no significant difference in the levels of 24 hours proteinuria, blood urea nitrogen (BUN), and serum creatinine between the two groups with different levels of serum uric acid (p > 0.05). The prevalence of glomerular sclerosis as well as the scores of tubulointerstitial and vascular injury was greater in patients with high serum uric acid levels compared to patients with normal levels of serum uric acid (p < 0.05). At the end of the follow-up period, patients with high serum uric acid levels had a higher prevalence of reduced GFR and end stage renal disease (ESRD) than those with normal serum uric acid levels (40.82 vs. 15.70% and 64.71 vs. 35.00%, respectively; p < 0.05). Conclusions: The serum uric acid level in patients with IgA nephropathy affects the pathophysiology and prognosis of the disease. We also identified a correlation between hyperuricemia and a higher risk of renal end points.