关键词: 肾小球肾炎, 膜增生性, 贫血, 病理状态, 体征和症状, 预后

Abstract: Objective　To analyze the clinicopathological features and prognosis in patients with proliferative and sclerosing IgA nephropathy with anemia.Methods　261 cases of proliferative and sclerosing IgA nephropathy diagnosed by renal biopsy were recruited from the First Affiliated Hospital of Zhengzhou University between January 2012 and June 2016 and divided into anemia group（100 cases with anemia） and non-anemia group（161 cases without anemia）（anemia was determined by the corresponding diagnostic criteria）.The demographic data，laboratory findings，histopathological examination results of renal biopsies were collected.All of them were followed up from the date of renal biopsy to June 1，2017.Kaplan-Meier method was used to draw the survival curve.Log-rank test and multivariate Cox proportional hazards regression model were adopted to explore the value of anemia in predicting the prognosis of patients.Results　Compared with non-anemia group，anemia group had much lower initial eGFR，serum albumin and calcium levels but higher urea，serum creatinine，phosphorus，24 h urine total protein（UTP） and percentage of glomeruli affected by sclerosis，as well as higher tubular atrophy and interstitial fibrosis levels（P<0.05）．The patients had a median follow-up time as 11（6，21）months.Survival analysis showed that patients with anemia had lower cumulative renal survival rate than those without（χ2=30.307，P<0.001）.Survival analyses statistically significant difference in the cumulative renal survival rate among patients with CKD3（χ2=22.066，P<0.001）．Multivariate Cox hazards regression analysis revealed that anemia〔HR=2.864，95%CI（1.611，5.093）〕，24 h UTP〔HR=1.164，95%CI（1.065，1.272）〕，percentage of glomeruli affected by sclerosis〔HR=3.858，95%CI（1.120，13.290）〕，tubular atrophy and interstitial fibrosis〔HR=1.902，95%CI（1.070，3.383）〕 were risk factors for proliferative and sclerosing IgA nephropathy developing into end-stage renal disease（P<0.05）.Conclusion　Proliferative and sclerosing IgA nephropathy with anemia patients with anemia showed worse clinicopathological features and lower cumulative renal survival rate compared with those without.Anemia was an independent risk factor for the development of proliferative and sclerosing IgA nephropathy.

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