Wang Yingying, Zhou Xiaochun, Cheng Gang, Zhu Rongrong, Qi Zizhao, Zhang Wenjun, Shu Hong, Wang Gouqin, Kong Yuke, Wang Jianqin
The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
Department of Nephrology, The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, People's Republic of China.
Int Urol Nephrol. 2025 Apr 12. doi: 10.1007/s11255-025-04511-4.
This investigation sought to examine the clinical and pathological characteristics, outcomes, and risk factors linked to the progression of renal function in adult-onset immunoglobulin A (IgA) vasculitis within a single center in northwest China.
Data were retrospectively gathered from cases of adult-onset IgA vasculitis recorded at a tertiary hospital in northwest China, covering the period from January 2013 to August 2024. During the follow-up, clinical information was compared between patients who advanced to chronic kidney disease (CKD) stage 3 and those who did not.
A sum of 1082 adult-onset IgA vasculitis patients (632 men; median age of 37 years) were included. Among patients with baseline proteinuria >0.5 g/24h (43.9%), 40.7% progressed to chronic kidney disease (CKD) stage 3, while 5.1% developed end-stage renal disease (ESRD). COX regression analysis indicated that older age, renal pathological grade IV, hypertension (HTN), diabetes, hyperlipidemia, and hyperuricemia were independent risk factors for CKD stage 3 progression in individuals with adult-onset IgA vasculitis.
Older age and comorbidities such as hypertension and diabetes significantly increase the risk of renal progression in adult-onset IgAV. Early management of these comorbidities may mitigate the risk of CKD progression.
本研究旨在探讨中国西北部某单一中心成年起病的免疫球蛋白A（IgA）血管炎患者的临床和病理特征、预后以及与肾功能进展相关的危险因素。
回顾性收集中国西北部一家三级医院2013年1月至2024年8月期间记录的成年起病IgA血管炎病例数据。在随访期间，比较进展至慢性肾脏病（CKD）3期的患者和未进展至该阶段的患者的临床信息。
共纳入1082例成年起病的IgA血管炎患者（632例男性；中位年龄37岁）。在基线蛋白尿>0.5 g/24小时的患者中（43.9%），40.7%进展至CKD 3期，5.1%发展为终末期肾病（ESRD）。COX回归分析表明，年龄较大、肾脏病理分级为IV级、高血压（HTN）、糖尿病、高脂血症和高尿酸血症是成年起病IgA血管炎患者CKD 3期进展的独立危险因素。
年龄较大以及高血压和糖尿病等合并症显著增加成年起病IgAV患者肾脏进展的风险。对这些合并症进行早期管理可能会降低CKD进展的风险。
