Clinicopathologic Features and Outcomes in Endocapillary Proliferative IgA Nephropathy
Clinicopathologic Features and Outcomes in Endocapillary Proliferative IgA Nephropathy
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DOI：
10.1159/000312880
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发表时间：
2010-01-01
影响因子：
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通讯作者：
Zhang, Hong
中科院分区：
文献类型：
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作者：
Liu, Li-jun;Li, Guang-tao;Zhang, Hong
目的：IgA 肾病的临床表现和组织学病变多种多样，并且与患者的肾脏结局相关。本研究的目的是阐明以弥漫性毛细血管内增生性病变为主的 IgA 肾病患者的临床病理特征和预后。方法：比较126例伴有和不伴有弥漫性毛细血管内增殖的患者的形态学和临床特征。 126 例中有 29 例是 IgA 肾炎患者，伴有弥漫性毛细血管内增殖。其他是没有弥漫性毛细血管内增殖的患者。分析2组患者的预后，并分析弥漫性毛细血管内增殖对不同肾功能患者肾病进展的影响。结果：弥漫性毛细血管内增生患者的蛋白尿 (p < 0.0001) 和新月体百分比 (p < 0.05) 显着升高。有或没有弥漫性毛细血管内增殖的患者的肾脏存活率没有显着差异。进一步分析表明，如果肾功能正常，弥漫性毛细血管内增殖患者的肾脏生存率高于无弥漫性毛细血管内增殖的患者（对数等级，p = 0.0561），而如果肾功能异常，弥漫性毛细血管内增殖患者的肾脏生存率则低于无弥漫性毛细血管内增殖的患者（对数等级，p = 0.0763）。结论：伴弥漫性毛细血管内增殖的IgA肾病在肾功能正常的患者中预后较好，但在肾功能异常的患者中是终末期肾病的相对危险因素。版权所有 (C) 2010 S. Karger AG，巴塞尔
Objective: Clinical manifestations and histological lesions of IgA nephropathy are variable and correlate with the renal outcome of the patient. The aim of the present study is to clarify the clinicopathological features and the prognosis of patients with IgA nephropathy presenting with dominant diffuse endocapillary proliferative lesions. Methods: The morphological and clinical features of 126 patients with and without diffuse endocapillary proliferation were compared. 29 out of 126 are IgA nephritis patients with diffuse endocapillary proliferation. The others are patients without diffuse endocapillary proliferation. The prognosis of the patients in the 2 groups was analyzed and the effects of diffuse endocapillary proliferation on renal progression in patients with different renal function were also analyzed. Results: Patients with diffuse endocapillary proliferation show significantly higher proteinuria (p < 0.0001) and crescent percent (p < 0.05). There is no significant difference of renal survival in patients with or without diffuse endocapillary proliferation. Further analysis indicated that patients with diffuse endocapillary proliferation had better renal survival than those without it (log rank, p = 0.0561) if their renal function was normal, whereas renal survival of patients with diffuse endocapillary proliferation was worse than of those without it if their renal function was abnormal (log rank, p = 0.0763). Conclusion: IgA nephropathy with diffuse endocapillary proliferation shows a better prognosis in the patients with normal renal function, but it is a relative risk factor for end-stage renal disease in patients with abnormal renal function. Copyright (C) 2010 S. Karger AG, Basel