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肾性贫血对 IgA 肾病病理的影响:基于倾向评分匹配的研究。

Influences of renal anemia on the pathology of IgA nephropathy: a study based on propensity score matching.

机构信息

Nankai University School of Medicine, Nankai University, Tianjin 300073, China.

Department of Nephrology, Chinese PLA Institute of Nephrology/State Key Laboratory of Kidney Diseases/National Clinical Research Center for Kidney Diseases/Beijing Key Laboratory of Kidney Disease/Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Discov Med. 2020 Jul-Aug;30(159):7-18.

Abstract

OBJECTIVE

This study aims to investigate the influences of renal anemia on the pathogenesis of IgA nephropathy using propensity score matching (PSM).

METHODS

Renal biopsies from 462 patients with IgA nephropathy were enrolled in this study. PSM was used to balance intergroup covariates, and matching results were verified using a dot-plot of standardized mean differences and histograms of the propensity score distribution and distance distribution. The matched data were used to analyze the impact of renal anemia on the pathological indicators of IgA nephropathy by logistic regression.

RESULTS

A total of 132 pairs of patients from the renal anemia group and the non-renal anemia group were matched by PSM; after matching, the standard deviations of 13 covariates were within 0.25. Multivariate logistic regression results suggested that the CKD4-5 stage of IgA nephropathy and tubular atrophy/interstitial fibrosis >50% were independent risk factors for renal anemia.

CONCLUSIONS

Via PSM, we demonstrated that decreased eGFR and severe tubular atrophy/interstitial fibrosis are correlated with renal anemia in IgA nephropathy. In clinical practice, renal anemia in patients with IgA nephropathy of CKD3 stage or above should be closely monitored and managed.

摘要

目的

本研究旨在通过倾向评分匹配(PSM)探讨肾性贫血对 IgA 肾病发病机制的影响。

方法

纳入 462 例 IgA 肾病患者的肾活检组织,采用 PSM 平衡组间协变量,通过标准化均数差值散点图、倾向评分分布直方图和距离分布直方图验证匹配结果。使用匹配后的数据,通过 logistic 回归分析肾性贫血对 IgA 肾病病理指标的影响。

结果

PSM 共匹配出肾性贫血组和非肾性贫血组各 132 对患者,13 个协变量的标准差均在 0.25 以内。多因素 logistic 回归结果提示 IgA 肾病的 CKD4-5 期和肾小管萎缩/间质纤维化>50%是肾性贫血的独立危险因素。

结论

通过 PSM,我们证实了 IgA 肾病患者 eGFR 降低和严重的肾小管萎缩/间质纤维化与肾性贫血有关。在临床实践中,应密切监测和管理 IgA 肾病 CKD3 期及以上患者的肾性贫血。

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