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特发性膜性肾病伴高尿酸血症的临床病理特征及相关因素:一项单中心横断面研究。

Clinicopathological characteristics and associated factors of idiopathic membranous nephropathy with hyperuricemia: a single-centered cross-sectional study.

机构信息

Department of Nephrology, Binzhou Medical University Hospital, Binzhou, 256600, China.

出版信息

Int Urol Nephrol. 2023 Sep;55(9):2275-2283. doi: 10.1007/s11255-023-03523-2. Epub 2023 Mar 3.

Abstract

PURPOSE

This study was designed to investigate the clinicopathological features of idiopathic membranous nephropathy (IMN) with hyperuricemia (HUA), together with associated factors within 10 years in a single centre in Shandong Province.

METHODS

In this cross-sectional study, we analysed the clinical and pathological data of 694 IMN patients in our hospital from January 2010 to December 2019. Based on serum uric acid (UA) level, the patients were divided into hyperuricemia (HUA) group (n = 213) and normal serum uric acid (NUA) group (n = 481). Multi-variate logistic regression analysis was conducted on to screen the associated factors of HUA.

RESULTS

213 (30.69%) IMN patient were complicated with HUA. Compared with the patients with NUA, significant increase was noticed in the proportion of patients showing edema, concurrent hypertensive disease or diabetes mellitus (DM), as well as the proportion of positive glomerular capillary loop IgM and positive C1q in the HUA group (P < 0.05). In addition, significant increase was noticed in the 24 h urine protein, serum creatinine, triglycerides, complement C3 and complement C4 in HUA group compared with those of NUA group (all P < 0.05). With gender as a control factor, multi-variate logistic regression analysis showed positive glomerular capillary loops C1q, serum albumin, serum phosphorus were associated with IMN combined with HUA in male, while triglycerides and serum creatinine were associated with IMN combined with HUA in female counterparts.

CONCLUSION

About 30.69% of IMN patients had HUA, with a male predominance than female. In male patients with IMN, higher serum albumin level and serum phosphorus level were associated with higher incidence of HUA, while in female IMN patients, higher serum triglyceridemia and serum creatinine level were associated with higher incidence of HUA. Therefore, it can be targeted to prevent the occurrence of HUA in IMN.

摘要

目的

本研究旨在探讨山东省某单一中心 10 年内特发性膜性肾病(IMN)伴高尿酸血症(HUA)的临床病理特征及相关因素。

方法

本横断面研究分析了我院 2010 年 1 月至 2019 年 12 月间 694 例 IMN 患者的临床和病理资料。根据血清尿酸(UA)水平,将患者分为高尿酸血症(HUA)组(n=213)和正常血清尿酸(NUA)组(n=481)。采用多变量 logistic 回归分析筛选 HUA 的相关因素。

结果

213 例(30.69%)IMN 患者并发 HUA。与 NUA 组相比,HUA 组患者水肿、并发高血压或糖尿病(DM)的比例以及肾小球毛细血管袢 IgM 和 C1q 阳性的比例显著升高(P<0.05)。此外,与 NUA 组相比,HUA 组 24 小时尿蛋白、血清肌酐、甘油三酯、补体 C3 和补体 C4 显著升高(均 P<0.05)。以性别为控制因素,多变量 logistic 回归分析显示,在男性中,阳性肾小球毛细血管袢 C1q、血清白蛋白、血清磷与 IMN 合并 HUA 相关,而在女性中,甘油三酯和血清肌酐与 IMN 合并 HUA 相关。

结论

约 30.69%的 IMN 患者存在 HUA,男性患病率高于女性。在男性 IMN 患者中,较高的血清白蛋白和血清磷水平与 HUA 的发生率较高相关,而在女性 IMN 患者中,较高的血清甘油三酯和血清肌酐水平与 HUA 的发生率较高相关。因此,可以针对 IMN 预防 HUA 的发生。

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