Choi Won Jung, Hong Yu A, Min Ji Won, Koh Eun Sil, Kim Hyung Duk, Ban Tae Hyun, Kim Young Soo, Kim Yong Kyun, Shin Seok Joon, Kim Seok Young, Kim Young Ok, Yang Chul Woo, Chang Yoon-Kyung
Department of Internal Medicine, Daejeon St. Mary's Hospital, Catholic University of Korea, Daejeon 34943, Korea.
Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon 14647, Korea.
J Clin Med. 2021 Apr 27;10(9):1885. doi: 10.3390/jcm10091885.
Hyperuricemia is a significant risk factor for cardiovascular morbidity and chronic kidney disease progression. IgA nephropathy (IgAN) is a well-known primary glomerular nephropathy. Hyperuricemia is associated with a poor prognosis in IgAN patients. We evaluated the association of hyperuricemia with the histopathological severity of IgAN in male and female patients; 658 patients diagnosed with IgAN via kidney biopsy were initially included. Baseline patient data were collected by eight university hospitals affiliated with the College of Medicine of the Catholic University of Korea. Pathological features were independently evaluated by eight expert pathologists working in the hospitals, and the consensus was reached. Of the initial 658 patients, 517 were finally included (253 males and 264 females). Hyperuricemia was defined as a serum uric acid (UA) level >7.0 mg/dL for males and >5.6 mg/dL for females; 108 (42.7%) males and 95 (35.9%) females exhibited hyperuricemia. Compared to the patients with normal UA levels, the global glomerulosclerosis, segmental sclerosis, mesangial matrix expansion (MME), endocapillary proliferation (ECP), interstitial fibrosis (IF), and tubular atrophy (TA) scores were higher in hyperuricemic males and females. In multivariable linear regression, the serum UA level correlated significantly with the MME, ECP, IF, and TA scores of female IgAN patients only.
高尿酸血症是心血管疾病发病和慢性肾脏病进展的重要危险因素。IgA肾病（IgAN）是一种众所周知的原发性肾小球疾病。高尿酸血症与IgAN患者的不良预后相关。我们评估了高尿酸血症与男性和女性IgAN患者组织病理学严重程度之间的关联；最初纳入了658例经肾活检诊断为IgAN的患者。韩国天主教大学医学院附属的八所大学医院收集了患者的基线数据。病理特征由在这些医院工作的八位专家病理学家独立评估，并达成共识。在最初的658例患者中，最终纳入517例（男性253例，女性264例）。高尿酸血症定义为男性血清尿酸（UA）水平>7.0mg/dL，女性>5.6mg/dL；108例（42.7%）男性和95例（35.9%）女性表现为高尿酸血症。与尿酸水平正常的患者相比，高尿酸血症的男性和女性患者的全球肾小球硬化、节段性硬化、系膜基质扩张（MME）、毛细血管内增生（ECP）、间质纤维化（IF）和肾小管萎缩（TA）评分更高。在多变量线性回归中，血清尿酸水平仅与女性IgAN患者的MME、ECP、IF和TA评分显著相关。
