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肾小球硬化与 IgA 肾病的肾炎相关临床参数有关。

Glomerular solidification is associated with nephritis-related clinical parameters in IgA nephropathy.

机构信息

Department of Nephrology, Faculty of Medicine, Saitama Medical University , Saitama , Japan.

Department of Nephrology, Shanxi Provincial People's Hospital , Taiyuan , China.

出版信息

Ren Fail. 2019 Nov;41(1):893-898. doi: 10.1080/0886022X.2019.1665545.

Abstract

Two types of global glomerulosclerosis, glomerular obsolescence and solidification, have been identified. A clinicopathological correlation between these glomerular changes and hypertensive nephrosclerosis has been reported; however, clinicopathological correlations with other kidney diseases are unknown. The aim of this study was to evaluate the correlation between the two glomerulosclerosis types and the clinical IgA nephropathy presentation. A single center, cross-sectional study of patients with IgA nephropathy was performed. Correlations between glomerulosclerosis and body mass index, mean blood pressure, creatinine-based estimated glomerular filtration rate (eGFR), total cholesterol, urinary protein corrected by urinary creatinine, and anti-hypertensive agent use were investigated using univariate and multivariate analyses. Overall, 116 patients were enrolled (male/female, 59/57; mean age, 40.5 ± 15.0 years). Separate analyses were performed for solidification and obsolescence glomerulosclerosis. Univariate analysis demonstrated a significant correlation between the percentage of solidification glomerulosclerosis and patient age, mean blood pressure, eGFR, and use of antihypertensive drugs. Multivariate analysis showed that only eGFR and use of antihypertensive drugs maintained their independent predictive value. The amount of urinary protein emerged as a significant factor based on the multivariate analysis. However, although the univariate analysis demonstrated a statistically significant correlation between the percentage of obsolescence and eGFR for obsolescence glomerulosclerosis, a multivariate analysis indicated that none of the factors maintained their independent predictive value. The incidence of solidification was better correlated with some nephritis-related clinical parameters compared with the incidence of obsolescence. The emergence of solidification may influence the clinical activities that are associated with IgA nephropathy.

摘要

已鉴定出两种类型的全球肾小球硬化症,即肾小球废弃和硬化。已经报道了这些肾小球变化与高血压性肾硬化之间的临床病理相关性;然而,与其他肾脏疾病的临床病理相关性尚不清楚。本研究旨在评估这两种肾小球硬化类型与 IgA 肾病临床表现之间的相关性。 对 IgA 肾病患者进行了单中心、横断面研究。使用单变量和多变量分析,研究了肾小球硬化与体重指数、平均血压、基于肌酐的估算肾小球滤过率 (eGFR)、总胆固醇、尿蛋白与尿肌酐校正比值以及抗高血压药物使用之间的相关性。 总体而言,共纳入 116 例患者(男/女,59/57;平均年龄,40.5±15.0 岁)。分别对硬化性和废弃性肾小球硬化进行了单独分析。单变量分析表明,硬化性肾小球硬化的百分比与患者年龄、平均血压、eGFR 和抗高血压药物的使用显著相关。多变量分析显示,只有 eGFR 和抗高血压药物的使用仍然具有独立的预测价值。基于多变量分析,尿蛋白量是一个显著因素。然而,尽管单变量分析表明废弃性肾小球硬化的废弃百分比与 eGFR 之间存在统计学显著相关性,但多变量分析表明,没有一个因素保持其独立的预测价值。 与 obsolescence 相比,solidification 的发生率与一些与肾炎相关的临床参数更好地相关。solidification 的出现可能会影响与 IgA 肾病相关的临床活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f457/7011875/f9f183bfdb5a/IRNF_A_1665545_F0001_C.jpg

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