Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
Department of Joint Laboratory for Translational Medicine Research, Liaocheng People's Hospital, Liaocheng, People's Republic of China.
Sci Rep. 2024 Mar 29;14(1):7457. doi: 10.1038/s41598-024-57813-5.
To investigate the relationship between serum uric acid level and glomerular ischemic lesions (GIL) in patients with primary membranous nephropathy (PMN) and identify relevant risk factors. A total of 201 patients with PMN but normal renal function confirmed by renal biopsy executed in the Liaocheng People's Hospital, China, during January 2020-January 2023 were analyzed retrospectively. The enrolled patients were divided into a hyperuricemia group and a normal serum uric acid group (control group) according to their serum uric acid levels. Then, the participants were further divided into a non-GIL group or a GIL group based on the patient's renal biopsy results. The two groups' clinical and pathological data and meaningful indicators for differences were analyzed by binary logistic regression analysis. Additionally, the serum uric acid level prediction value on GIL was investigated using receiver operating characteristic (ROC) curves. Compared with the control group, the hyperuricemia group exhibited high serum uric acid, the prevalence of GIL, serum albumin, the prevalence of hypertension, and low-density lipoprotein cholesterol (LDL) levels (P < 0.05). Compared with the non-GIL group, the GIL group exhibited were older, had enhanced serum uric acid, serum albumin, and an increased prevalence of tubular atrophy/interstitial fibrosis (TA/IF), arteriolosclerosis, and low eGFR levels (P < 0.05). The binary logistic regression analysis revealed that the serum uric acid and the TA/IF are independent risk factors of GIL (P < 0.05). The AUC of ROC of GIL of PMN patients, predicted based on the serum uric acid concentration, was 0.736 (P < 0.05), wherein the threshold = 426.5 μmol/L and the Youden's index = 0.41. Serum uric acid concentration and the TA/IF are independent risk factors of GIL in patients with PMN, and the former exhibits prediction value on GIL in patients with PMN.
探讨原发性膜性肾病（PMN）患者血清尿酸（UA）水平与肾小球缺血性病变（GIL）的关系，并确定相关危险因素。
回顾性分析 2020 年 1 月至 2023 年 1 月在中国聊城市人民医院行肾活检证实肾功能正常的 201 例 PMN 患者的临床资料。根据 UA 水平，将纳入患者分为高尿酸血症组和正常 UA 组（对照组）。根据患者肾活检结果，将患者进一步分为非 GIL 组或 GIL 组。采用二元逻辑回归分析比较两组的临床病理资料和差异有统计学意义的指标。采用受试者工作特征（ROC）曲线探讨 UA 对 GIL 的预测价值。
与对照组相比，高尿酸血症组 UA、GIL 发生率、白蛋白、高血压发生率、低密度脂蛋白胆固醇（LDL）水平较高（P<0.05）。与非 GIL 组相比，GIL 组年龄较大，UA、白蛋白、肾小管萎缩/间质纤维化（TA/IF）、小动脉硬化、肾小球滤过率（eGFR）降低的发生率较高（P<0.05）。二元逻辑回归分析显示，UA 和 TA/IF 是 GIL 的独立危险因素（P<0.05）。ROC 曲线分析显示，PMN 患者 GIL 的 AUROC 为 0.736（P<0.05），截断值为 426.5 μmol/L，Youden 指数为 0.41。PMN 患者 UA 浓度和 TA/IF 是 GIL 的独立危险因素，前者对 PMN 患者 GIL 有预测价值。
