Yu Pao, Zhang Pei, Gao Chun-Lin, Wang Zi, Zhang Yin, Ge Zheng, Zhou Bi
Department of Pediatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing 210000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Jan 15;27(1):55-61. doi: 10.7499/j.issn.1008-8830.2408058.
To study the significance of serum 25-hydroxyvitamin D [25-(OH)D] level in the clinicopathological characteristics and prognosis of children with immunoglobulin A vasculitis nephritis (IgAVN).
A retrospective analysis was conducted on the clinical data of children with IgAVN who underwent renal biopsy at Suzhou Hospital Affiliated to Anhui Medical University and Jinling Hospital of the Medical School of Nanjing University from June 2015 to June 2020. Based on serum 25-(OH)D level, the patients were divided into a normal group and a lower group. The clinicopathological characteristics and follow-up data of the two groups were collected and compared.
A total of 359 children with IgAVN were included. Compared to the normal group (62 cases), the lower group (297 cases) exhibited higher incidences of hematochezia and gross hematuria, higher levels of serum creatinine, blood urea nitrogen, urinary retinol protein, urinary N-acetyl-β-D-glucosaminidase, and quantitative urinary protein, and a longer duration from renal biopsy to urinary protein becoming negative, as well as lower estimated glomerular filtration rate and albumin level (<0.05). Renal pathology in the lower group showed a higher occurrence of tubular interstitial injury, crescent formation, segmental sclerosis in glomeruli, and inflammatory cell infiltration in the renal interstitium compared to the normal group (<0.05). Survival analysis indicated that the cumulative renal survival rate was lower in the lower group (<0.05). Multivariate Cox regression analysis revealed that low serum 25-(OH)D level is an independent risk factor for poor prognosis in children with IgAVN.
Children with IgAVN and low serum 25-(OH)D level have relatively severe clinicopathological manifestations. Low serum 25-(OH)D level is an independent risk factor for poor prognosis in children with IgAVN.
探讨血清25-羟基维生素D[25-(OH)D]水平在儿童免疫球蛋白A血管炎肾损害（IgAVN）临床病理特征及预后中的意义。
回顾性分析2015年6月至2020年6月在安徽医科大学附属苏州医院和南京大学医学院附属金陵医院行肾活检的IgAVN患儿的临床资料。根据血清25-(OH)D水平将患儿分为正常组和降低组。收集并比较两组的临床病理特征及随访资料。
共纳入359例IgAVN患儿。与正常组（62例）相比，降低组（297例）便血和肉眼血尿发生率更高，血清肌酐、血尿素氮、尿视黄醇蛋白、尿N-乙酰-β-D-氨基葡萄糖苷酶及尿蛋白定量水平更高，肾活检至尿蛋白转阴时间更长，估算肾小球滤过率及白蛋白水平更低（<0.05）。降低组肾病理显示肾小管间质损伤、新月体形成、肾小球节段性硬化及肾间质炎性细胞浸润的发生率高于正常组（<0.05）。生存分析表明降低组累积肾脏生存率更低（<0.05）。多因素Cox回归分析显示血清25-(OH)D水平降低是IgAVN患儿预后不良的独立危险因素。
血清25-(OH)D水平降低的IgAVN患儿临床病理表现相对严重。血清25-(OH)D水平降低是IgAVN患儿预后不良的独立危险因素。
