Tubular lesions determine prognosis of IgA nephropathy
Tubular lesions determine prognosis of IgA nephropathy
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DOI：
10.1016/s0272-6386(00)70295-2
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发表时间：
2000-01-01
影响因子：
13.2
通讯作者：
Berland, Y
中科院分区：
文献类型：
--
作者：
Daniel, L;Saingra, Y;Berland, Y
为评价组织学分型对肾脏预后的价值，我们对1985年至1995年194例伊加肾病患者进行了多因素分析，并对肾小管病变和血管病变的半定量评分进行了评价。在随访结束时，33例患者（17%）需要血液透析。患者的平均年龄为37.8 ± 18.9岁，男性占多数（性别比：3.12），患者平均随访43.2 ± 37.2个月。单因素分析显示，高血压（P < 10（-4）），肾病综合征（P = 0.01），新月形（P = 0.02）在预测肾功能衰竭方面具有显著性，与伊加沉积的内皮下地形不同（P = 0.05）和蛋白尿血尿为保护因素（P = 0.05）多因素分析显示肾小管2级（RR = 5.5）和肾小管3级（RR = 28.8）是预测慢性肾功能衰竭的最佳因素。哈斯组织学分型在单因素分析中有显著性差异，但在多因素分析中无显著性差异。肾小管分级预测肾脏预后优于其他组织学参数。(C)2000年由国家肾脏基金会，公司。
To assess the prognostic value of histological classification for renal outcome, we did a multivariate analysis of 194 patients with immunoglobulin A (IgA) nephropathy between 1985 and 1995, We also evaluated semiquantitative scales of tubular lesions and vessel lesions, At the time of the biopsy, 65 patients (33.5%) had chronic renal failure. At the end of the follow-up, 33 patients (17%) required hemodialysis. The mean age of the patients was 37.8 +/- 18.9 years with predominance of men (sex-ratio: 3.12), Patients were followed-up for a mean of 43.2 +/- 37.2 months. Univariate analysis showed that hypertension (P < 10(-4)), nephrotic syndrome (P = 0.01), and crescents (P = 0.02) were significant in predicting renal failure, unlike subendothelial topography of IgA deposits (P = 0.05) and proteinuria (P = 0.05), Hematuria was a protective factor (P = 0.03), Multivariate analysis showed that tubular grade 2 (relative risk [RR], 5.5) and tubular grade 3 (RR = 28.8) were the best factors to predict chronic renal failure. The histological classification of Haas was significant in the univariate analysis, but not in the multivariate analysis. Tubular grading predicted renal outcome better than did the other histological parameters. (C) 2000 by the National Kidney Foundation, Inc.