Clinicopathologic analysis of IgA nephropathy patients with anemia

摘要

Objective:To explore the clinicopathological characteristics of IgA nephropathy(IgAN)patients with anemia.Methods:The clinical and pathological data of patients diagnosed with primary IgAN at the Renmin Hospital of Wuhan University from January 2017 to December 2019 were colleted.The patients were divided into anemia group and without anemia group based on the pressure value when performing the Kidney kidney biopsy.Compare the data of the two groups of patients.Results:A total of 314 subjects were enrolled,including 181 females(57.64%),and the female-male ratio was 1.36∶1.Their age was(37±13)years.There were 113 patients(35.99%)in anemia group,201 cases(64.01%)in non-anemic group.Univariate analysis showed that compared with non-anemia group,anemia group had higher serum creatinine and 24h urine protein levels,higher proportion of females and eGFR<60 ml·min^(-1)·(1.73m^(2))^(-1),lower serum albumin,higher proportion of tubular atrophy/interstitial fibrosis(T1/2),endothelial cell proliferation(E1)and crescent formation(C1/2),which were statistically significant(all P<0.05).Anemia group had a higher proportion of Ⅳ~Ⅴlevel in Lee''s classification.There was a difference in Lee''s grading composition between the two groups,and the difference was statistically significant(P<0.01).Spearson correlation analysis showed that the glomerular and tubulointerstitial lesions were negatively correlated with serum hemoglobin、albumin and eGFR,but positively corelated with proteinuria(P<0.05).Multivariate Logistic regression analysis found that decreased serum albumin level,increased serum creatinine and hypertension were independent risk factors for anemia in IgAN patients.Conclusions:Anemia can aggravate the pathological damage and clinical manifestations in patients with IgA nephropathy.The anemia must be corrected in time during treatment and follow-up.At the same time.it should be paid more attention to the changes of serum albumin level,blood pressure monitoring and the protection of renal function.