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克罗恩病相关 IgA 肾病可能更倾向于良好的肾脏预后。

Crohn's disease-associated IgA nephropathy may prone to better renal outcome.

机构信息

The Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Biomedical Innovation Center, Guangzhou, Guangdong, China.

The Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Biomedical Innovation Center, Guangzhou, Guangdong, China.

出版信息

Int Urol Nephrol. 2024 Dec;56(12):3815-3824. doi: 10.1007/s11255-024-04106-5. Epub 2024 Jun 21.

Abstract

BACKGROUND AND AIM

Renal involvement in Crohn's Disease (CD) was rare in the population. Little was known between IgA nephropathy and CD. This study aimed to investigate the differences in clinical and outcome features of CD-associated IgA nephropathy (CD-IgAN) and primary IgA nephropathy (PIgAN).

METHODS

Clinical data of patients diagnosed with IgAN by kidney biopsy were collected in the Sixth Affiliated Hospital of Sun Yat-sen University from January 1st, 2016 to June 1st, 2023. 17 patients with CD-IgAN and 87 patients with PIgAN were enrolled in this retrospective study.

RESULTS

Compared with PIgAN patients, CD-IgAN patients had lower levels of urinary protein excretion (1.57 g per 24 h vs. 0.33 g per 24 h, p < 0.01), but higher levels of estimated glomerular filtration rate (77.63 ± 40.11 ml per min per 1.73m vs. 104.53 ± 32.97 ml per min per 1.73m, p = 0.008). From the point of renal pathology of PIgAN, patients with CD-IgAN had a less incidence of tubular atrophy or interstitial fibrosis (p = 0.001). CD-IgAN patients had a higher incidence of complete remission of proteinuria (45.8% vs. 81.8%, p = 0.031) or hematuria (10.4% vs. 45.4%, p = 0.019) than PIgAN patients after twelve-month treatments.

CONCLUSIONS

CD-IgAN manifests a milder progression of renal function than those PIgAN. After the treatment, proteinuria or hematuria are more prone to remit in patients with CD-IgAN.

摘要

背景与目的

克罗恩病(CD)患者肾脏受累较为罕见,IgA 肾病与 CD 之间的相关性知之甚少。本研究旨在探讨 CD 相关 IgA 肾病(CD-IgAN)与原发性 IgA 肾病(PIgAN)患者的临床及预后特征差异。

方法

收集中山大学附属第六医院 2016 年 1 月 1 日至 2023 年 6 月 1 日经肾活检诊断为 IgA 肾病患者的临床资料,纳入本回顾性研究的 17 例 CD-IgAN 患者和 87 例 PIgAN 患者。

结果

与 PIgAN 患者相比,CD-IgAN 患者尿蛋白排泄量更低(1.57 g/24 h 比 0.33 g/24 h,p < 0.01),估算肾小球滤过率(eGFR)更高(77.63 ± 40.11 ml/min/1.73m 比 104.53 ± 32.97 ml/min/1.73m,p = 0.008)。从 PIgAN 患者的肾脏病理来看,CD-IgAN 患者发生肾小管萎缩或间质纤维化的比例较低(p = 0.001)。经过 12 个月的治疗后,CD-IgAN 患者蛋白尿完全缓解的比例(45.8%比 81.8%,p = 0.031)或血尿完全缓解的比例(10.4%比 45.4%,p = 0.019)均高于 PIgAN 患者。

结论

CD-IgAN 患者的肾功能恶化程度较 PIgAN 患者轻。经过治疗后,CD-IgAN 患者的蛋白尿或血尿更容易缓解。

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