IgA肾病合并高血压病88例临床病理特点分析

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Abstract Objective: To study the clinical and pathological features of primary IgA nephropathy (IgAN) combined with primary hypertension in 88 cases. Methods: A retrospective case series of 88 patients who were diagnosed as IgAN by renal biopsy and diagnosed with primary hypertension by clinical in our hospital between January 1997 to June 2013. Results: The mean age of the 88 cases of IgAN with hypertension was (44.7±11.27) years. Their hypertension history (median 36 months) was longer than IgAN’s (2 months). Forty-eight cases had family hypertension history, accounting for 54.5%. Sixty-six cases (75.0%) showed asymptomatic urine abnormalities, followed by 10.2% nephrotic syndrome and 11.4% chronic nephritis. Among the 29 cases (33.0%) of renal dysfunction (eGFR<90 mL/min), there were 6 cases (6/9) with the low-gravity urine and 21 cases (21/29) with the high NAG enzyme urine. Among the 88 cases, 52 cases (52/87) had the left ventricular wall thickening and (or) left atrial enlargement change, and 76 cases (76/80) had hypertension retinopathy. The renal biopsy showed Haas 1～3 grade level together accounted for 87.5% of lesions, severe glomerular sclerosis accounted for 19.3%, cases of moderate to severe renal interstitial disease accounted for 34.1%, and renal small artery disease accounted for 78.4%. Conclusion: The clinical and pathological manifestations of IgAN combined with hypertension patients are mostly mild; the cases of low eGFR mostly complicated with renal tubular dysfunction; the renal biopsy shows most glomerular lesion is mild, whereas the renal tubulo-interstitial and renal artery lesion is severe.Some cases show that tubulointerstitial lesions and glomerular lesions do not parallel, and the renal small artery lesions are exist. In IgAN patients with hypertension, the blood pressure may be the main factor to affect the renal prognosis.

Key words： IgA-nephropathy hypertension pathology clinical secondary hypertension

Received: 23 June 2015

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	CHEN Qianqian
	HUANG Chaoxing

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2016/V46/I3/199

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