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狼疮性肾炎合并高尿酸血症患者的临床病理模式及预后

Clinicopathological Patterns and Outcomes in Patients with Lupus Nephritis and Hyperuricemia.

作者信息

Wen Qiong, Tang Xueqing, Zhou Qian, Chen Wei, Yu Xueqing

机构信息

Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China.

出版信息

J Clin Med. 2022 May 30;11(11):3075. doi: 10.3390/jcm11113075.

Abstract

A limited number of large cohort studies have reported the clinicopathological characteristics and prognosis of patients with lupus nephritis (LN) and hyperuricemia (HUA). In this retrospective cohort study, 1297 LN patients were enrolled from January 1996 to December 2011 in the First Affiliated Hospital of Sun Yat-Sen University, and HUA occurred in 649 (50.04%) of these 1297 LN patients. Compared to patients without HUA, those with HUA presented with higher blood pressure and triglyceride levels, lower hemoglobin and serum albumin levels, worse renal function, more severe hematuria and proteinuria, higher lupus activity, and more positive antiphospholipid antibody. Pathologically, HUA cases presented more crescents, a higher degree of mesangial matrix, endothelial cell proliferation, and inflammatory cell infiltration. During the 52-month follow-up, the 5-year and 10-year incidence rates of renal endpoint events were 11.1% and 19.5% in the HUA group, and 8.3% and 13.8% in the non-HUA group, respectively ( = 0.073). In addition, the 5-year and 10-year mortality rates did not differ significantly between the HUA (12.0% and 18.2%) and non-HUA (12.2% and 17.5%) groups, respectively. This study verified that HUA was not an independent risk for poor clinical outcomes, and steroids that delay the deterioration of renal function did not affect the survival of these patients.

摘要

少数大型队列研究报告了狼疮性肾炎(LN)合并高尿酸血症(HUA)患者的临床病理特征及预后。在这项回顾性队列研究中,1996年1月至2011年12月期间,中山大学附属第一医院纳入了1297例LN患者,其中649例(50.04%)发生了HUA。与无HUA的患者相比,有HUA的患者血压和甘油三酯水平更高,血红蛋白和血清白蛋白水平更低,肾功能更差,血尿和蛋白尿更严重,狼疮活动度更高,抗磷脂抗体阳性更多。病理上,HUA病例出现更多新月体、更高程度的系膜基质、内皮细胞增殖和炎症细胞浸润。在52个月的随访期间,HUA组肾脏终点事件的5年和10年发生率分别为11.1%和19.5%,非HUA组分别为8.3%和13.8%( = 0.073)。此外,HUA组(12.0%和18.2%)与非HUA组(12.2%和17.5%)的5年和10年死亡率分别无显著差异。本研究证实,HUA并非临床预后不良的独立危险因素,延缓肾功能恶化的类固醇药物并不影响这些患者的生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c58/9181739/9e5c163edab1/jcm-11-03075-g001.jpg

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