Hyperuricemia and hypertriglyceridemia indicate tubular atrophy/interstitial fibrosis in patients with IgA nephropathy and membranous nephropathy

Liu, Bingman; Zhao, Liangyu; Yang, Qingqing; Zha, Dongqing; Si, Xiaoyan

doi:10.1007/s11255-021-02844-4

Cited by 16 publications

(12 citation statements)

References 39 publications

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“…Uric acid can induce systemic and local inflammatory responses, oxidative stress, and activation of the local renin–angiotensin system, leading to endothelial dysfunction and glomerular hypertension [ 13 ], which result in the emergence of proteinuria. Hyperuricemia is an independent risk factor for renal tubular atrophy and interstitial fibrosis [ 14 , 15 ], and high baseline blood uric acid level is an independent predictor of poor renal outcome in PMN patients [ 15 ]. Therefore, it is of great significance to pay attention to the management of uric acid in clinical practice, the treatment of lowering uric acid should be given at the same time while treating the primary disease.…”

Section: Discussionmentioning

confidence: 99%

A preliminary nomogram model for predicting relapse of patients with primary membranous nephropathy

Wang

Lai

et al. 2023

Renal Failure

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Objective To explore the predictive factors and establish a nomogram model for predicting relapse risk in primary membranous nephropathy (PMN). Methods The clinical, laboratory, pathological and follow-up data of patients with biopsy-proven membranous nephropathy were collected in the Affiliated Hospital of Qingdao University. A total of 400 PMN patients who achieved remission were assigned to the development group ( n = 280) and validation group ( n = 120) randomly. Cox regression analysis was performed in the development cohort to determine the predictive factors of relapse in PMN patients, a nomogram model was established based on the multivariate Cox regression analysis and validated in the validation group. C-index and calibration plots were used to evaluate the discrimination and calibration performance of the model respectively. Result Hyperuricemia (HR = 2.938, 95% CI 1.875–4.605, p < 0.001), high C-reactive protein (CRP) (HR = 1.147, 95% CI 1.086–1.211, p < 0.001), and treatment with calcineurin inhibitors with or without glucocorticoids (HR = 2.845, 95%CI 1.361–5.946, p = 0.005) were independent risk factors, while complete remission (HR = 0.420, 95%CI 0.270–0.655, p < 0.001) was a protective factor for relapse of PMN according to multivariate Cox regression analysis, then a nomogram model for predicting relapse of PMN was established combining the above indicators. The C-indices of this model were 0.777 (95%CI 0.729–0.825) and 0.778 (95%CI 0.704–0.853) in the development group and validation group respectively. The calibration plots showed that the predicted relapse probabilities of the model were consistent with the actual probabilities at 1, 2 and 3 years, which indicated favorable performance of this model in predicting the relapse probability of PMN. Conclusions Hyperuricemia, remission status, CRP and therapeutic regimen were predictive factors for relapse of PMN. A novel nomogram model with good discrimination and calibration was constructed to predict relapse risk in patients with PMN early.

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Section: Discussionmentioning

confidence: 99%

A preliminary nomogram model for predicting relapse of patients with primary membranous nephropathy

Wang

Lai

et al. 2023

Renal Failure

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“…There is evidence that persistent hyperuricemia can cause renal tissue changes, such as arteriolonephrosclerosis, glomerulosclerosis and renal tubular lesions, leading to chronic kidney disease [ 4 , 5 ]. As Russo E et al reported in a retrospective study, Serum uric levels are independently associated with AD and poor prognosis in patients with IgAN [ 6 ].One of the mechanisms serum uric acid aggravates renal ischemic injury may be the activation of the renin–angiotensin system.…”

Section: Discussionmentioning

confidence: 99%

The relationship between serum uric acid levels and glomerular ischemic lesions in patients with Immunoglobin A nephropathy-a analytical cross-sectional study

Fang

Dong

et al. 2022

BMC Nephrol

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Background To investigate the relationship between serum uric acid levels and glomerular ischemic lesions in patients with immunoglobulin A nephropathy (IgAN) and the relevant risk factors. Methods A total of 86 patients with IgAN and normal renal functions were divided into a hyperuricemia group and a normal serum uric acid group (control group). These patients were further divided into a glomerular ischemic lesions group and a non-glomerular ischemic lesions group (control group) based on the renal biopsy results. The relationship between serum uric acid levels and glomerular ischemic lesions was analysed. Results In patients with IgAN, the prevalence or occurrence of glomerular ischemic lesions was significantly higher in the hyperuricemia group compared with the normal serum uric acid group. Elevated serum uric acid levels are independently associated with glomerular ischemic disease. Conclusion Hyperuricemia in patients with IgAN may lead to glomerular ischemic lesions, and lowering serum uric acid levels may delay the progression of IgAN.

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“…Consistently, in the present study, T1–T2 was a risk factor for poor prognosis of IgAN, even with relevant adjustment in the multivariable analysis models, and the frequency of T1–T2 among patients with higher levels of TA-SUA was also higher, especially in women. Recent research has established that hyperuricemia and hypertriglyceridemia, which are prevalent in patients with CKD, are independent risk factors for moderate tubular atrophy/interstitial fibrosis ( Liu et al, 2021 ), and by multivariate logistic regression analysis, only tubular atrophy/interstitial fibrosis (T1–T2) (HR = 3.969, P = 0.008) was significantly associated with hyperuricemia in IgAN ( Ruan et al, 2018 ). This suggests that we can combine the pathological characteristics and clinical follow-up data into a model for predicting the progression of IgAN.…”

Section: Discussionmentioning

confidence: 99%

Association of time-averaged serum uric acid level with clinicopathological information and long-term outcomes in patients with IgA nephropathy

Weng,

Fu,

Zhuo

et al. 2024

PeerJ

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Objective Whether serum uric acid (SUA) at baseline could been identiûed as a risk factor for progression in IgA nephropathy (IgAN) patients remains unclear, therefore, long- term SUA control levels must be monitored. We aimed to investigate the relevant factors affecting time-averaged SUA (TA-SUA) and to assess the prognostic value of TA-SUA in IgAN. Methods This retrospective study included 152 patients with IgAN. The relationships between TA-SUA and clinicopathological features and renal outcomes (defined as the doubling of the baseline serum creatinine level or end-stage renal disease) were analyzed in groups divided by quartiles of TA-SUA levels, the presence of hyperuricemia, and sex. Results Patients with high TA-SUA levels had higher levels of baseline SUA, blood urea nitrogen (BUN), triglycerides, serum C3 and serum C4 and were more likely to be male and have hypertension, proteinuria, poor renal function, and pathological injuries including high grades of tubular atrophy/interstitial fibrosis (T1–T2). These patients had a poorer prognosis compared with patients with low TA-SUA levels. The TA-SUA level was positively correlated with baseline age and BUN, triglycerides, serum C3, and serum C4 levels, and negatively correlated with baseline eGFR. Survival curve analysis indicated that persistent hyperuricemia was associated with significantly poorer renal outcomes than normo-uricemia in both men and women. The TA-SUA level also was an independent predictor of renal outcome in patients with IgAN, with optimal cutoû values of 451.38 µmol/L (area under the curve (AUC) = 0.934) for men and 492.83 µmol/L (AUC = 0.768) for women. Conclusions The TA-SUA level is associated with triglyceride level, complement component levels, renal function, and pathological severity of IgAN, and it may be a prognostic indicator in male and female patients with IgAN.

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Hyperuricemia and hypertriglyceridemia indicate tubular atrophy/interstitial fibrosis in patients with IgA nephropathy and membranous nephropathy

Cited by 16 publications

References 39 publications

A preliminary nomogram model for predicting relapse of patients with primary membranous nephropathy

A preliminary nomogram model for predicting relapse of patients with primary membranous nephropathy

The relationship between serum uric acid levels and glomerular ischemic lesions in patients with Immunoglobin A nephropathy-a analytical cross-sectional study

Association of time-averaged serum uric acid level with clinicopathological information and long-term outcomes in patients with IgA nephropathy

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