Objective To analyze the
risk factors and correlation between clinical
indicators and the four main pathological lesions of
IgA ne?phropathy in the Oxford
classificationmesangial hypercellularity(M0/1),endocapillary proliferation(E0/1),segmental
sclerosis or adhesion(S0/1), and tubular
atrophy/interstitial
fibrosis(T0/1/2).
Methods Clinical and pathological data were collected from 514
patients with
biopsy?proven
IgA nephropathy admitted in our
hospital from February 17,2006 to October 11,2011. These
patients were all above 18 years old. Cases with sec?ondary causes of mesangial
IgA deposition were excluded,such as Henoch?chonlein
purpura,
ankylosing spondylitis and
psoriasis et al. The inde?pendent
risk factors affecting the pathological
classification were analyzed by Spearman rank correlation
analysis and two?category and multi?classi?fication
logistic regression using SPSS 17.0 statistical
software. Results In 514 IgAN
patients,the ratio of
males to
females was 1.061. The aver?age age was 35.70±11.99 years,and the average
disease duration was 18.31±30.42 months. M0E0S0T0 was the major pathologic
classification of isolated
hematuria.
Chronic kidney disease(CKD)stage,24 hours
proteinuria,
albuminuria,
urine transferrin and
IgG levels were positively corre? lated with M lesion;
serum albumin,C3 and PLT showed a negative correlation with M lesion. Twenty four hours
proteinuria and
blood platelet count were the independent
risk factors for M lesion. As shown by stratified
analysis ,the proportion of M1 in cases with 24 hours
proteinuria≥3.5 g/d is much higher than that in cases with non?nephrotic range
proteinuria. Age,systolic
blood pressure,uRBC,24 hours
proteinuria,
albuminuria urine transferrin and
IgG levels were positively correlated with E lesion,Duration,
serum albumin showed a negative correlation with E lesion. Age and duration of
nephritis were independent
risk factors for E lesion. 73.3%of
patients that above 60 years old showed endothelial proliferation. CKD stage,24 hours
proteinuria were positively correlated with S lesion. Age,CKD stage,systolic
blood pressure,diastolic
blood pressure,C4,TC, LDL?C,CRP,Fib,UA,Cys?C and 24 hours
proteinuria,
urineβ2?microglobulin,
albumin,
transferrin and
IgG levels were positively associated with T lesion;
hemoglobin,
serum albumin,
serum IgG showed a negative correlation with T lesion.
Infection history,high CRP levels,DBP more than 90 mmHg,
hypoalbuminemia,high low density lipoproteinemia,and
anemia were independent
risk factors for T lesion. Conclusion Twenty four hours
proteinuria,
blood platelet count,age,duration of
nephritis,
hypoalbuminemia,
anemia,
hyperlipidemia,DBP≥90 mmHg and high CRP lev?els were
risk factors for the Oxford
classification of
IgA nephropathy. Renal
biopsy should be carried out in
time to make clear the pathological clas?sification and individual
treatment,so as to improve the
prognosis.