Liu Simeng, Gong Yijun, Ren Hong, Zhang Wen, Chen Xiaonong, Zhou Tong, Li Xiao, Chen Nan
Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
HBI Solutions Inc, Palo Alto, CA, USA.
Oncotarget. 2017 Jul 6;8(34):57099-57108. doi: 10.18632/oncotarget.19051. eCollection 2017 Aug 22.
There is a high prevalence of hyperuricemia (HUA) in the chronic kidney disease (CKD) population. However, there's a dearth of research on HUA's prevalence, subtypes, early detection, and treatment strategies of HUA in lupus nephritis (LN) patients. The aim of this study is to address these knowledge gaps. LN patients presenting to the Department of Nephrology at Shanghai Rui Jin Hospital from January 2011 to January 2016 were recruited. The effective sample size was derived using the power analysis. The demographic, clinical and laboratory characteristics of the LN patients with HUA were compared with those of patients without HUA. Two statistical models for analyzing HUA were built and compared using the receiver operating characteristic (ROC) curve analysis. The total prevalence of HUA in the cohort was 40.11%. The subtypes of HUA included urate underexcretion-type, overproduction-type and combined-type, which proportion being 67.7%, 9.7% and 22.6% respectively. The CKD stage was closely associated with the prevalence of HUA in patients with LN. The other significant associated factors were hypertension, triglycerides, serum creatinine, serum albumin, hemoglobin, parathyroid hormone, phosphorus, calcium, etc. The statistical algorithm successfully identified LN patients at risk of HUA. In conclusion, there was a high prevalence of HUA in LN patients at CKD stages 1-3, and renal underexcretion hyperuricemia was the most prevalent subtype. The occurrence of HUA in LN may be related to renal insufficiency, metabolic disorder and lupus itself. Early care coordination programs can employ risk models to improve HUA prevention and target interventions in LN patients.
慢性肾脏病（CKD）人群中高尿酸血症（HUA）的患病率很高。然而，关于狼疮性肾炎（LN）患者中HUA的患病率、亚型、早期检测及治疗策略的研究却很匮乏。本研究旨在填补这些知识空白。招募了2011年1月至2016年1月期间在上海瑞金医院肾病科就诊的LN患者。通过效能分析得出有效样本量。将HUA的LN患者的人口统计学、临床和实验室特征与无HUA的患者进行比较。构建了两种分析HUA的统计模型，并使用受试者工作特征（ROC）曲线分析进行比较。该队列中HUA的总患病率为40.11%。HUA的亚型包括尿酸排泄减少型、生成过多型和混合型，其比例分别为67.7%、9.7%和22.6%。CKD分期与LN患者中HUA的患病率密切相关。其他显著相关因素包括高血压、甘油三酯、血清肌酐、血清白蛋白、血红蛋白、甲状旁腺激素、磷、钙等。该统计算法成功识别出有HUA风险的LN患者。总之，在CKD 1-3期的LN患者中HUA患病率很高，且肾脏排泄减少型高尿酸血症是最常见的亚型。LN中HUA的发生可能与肾功能不全、代谢紊乱及狼疮本身有关。早期护理协调项目可采用风险模型来改善LN患者中HUA的预防及靶向干预。
