Clinical and pathologic characteristics of IgA nephropathy with malignant hypertension and acute kidney injury
ZHAO Hai-dan
ZHOU Chun-hua
HE Ping
Abstract：Objective To analyze the clinical pathological characteristics and prognosis of IgA nephropathy with malignant hypertension(MHT) and acute kidney injure(AKI).Methods The clinical and histological data of 12 cases with IgA nephropathy,accompanied with MHT and AKI( MHT IgA nephropathy group),and 15 IgA nephropathy cases without MHT and AKI(non-MHT IgA nephropathy gourp) were analyzed retrospectively.Results Of the 12 patients of MHT IgA nephropathy group,6 cases had progressive glomerulonephritis syndrome,4 cases were nephrotic syndrome and 3 cases represented gross hematuria.The other 6 patients manifested microscope hematuria,proteinuria(24 h proteinuria higher than or equal to 1.5 g/d) and AKI.All the patients in MHT IgA nephropathy group showed accelerated kidney function loss during follow-up.In non-MHT IgA nephropathy gourp,8 cases were chronic glomerulonephritis,3 cases were nephritic syndrome,1 case was latent glomerulonephritis and 3 cases showed gross hematuria.Kidney function did not show deteriorated tendency during follow-up.Duration of renal biopsy development in MHT IgA nephropathy patients were much longer than that in non-MHT IgA nephropathy group[ (22 ± 16)d vs(85 ±62)d,P ＜0.01 ].Compared with non-MHT IgA nephropathy,serum creatinine,uric acid,IgA,C-reactive protein and urine protein levels in MHT IgA nephropathy group were significantly incrased [ (242 ± 92) μmol/L vs (85 ± 14) μmol/L,P ＜0.01; (486 ± 121) μnol/L vs(358 ± 100) μmol/L,P ＜0.01 ;(4.8 ±1.3)g/L vs(3.6±1.3)g/L,P ＜0.05; (13 ± 8) mg/L vs(6 ±4)mg/L,P ＜0.01 ; (3.2 ± 1.3) g/d vs(2.2 ±1.2 )g/d,P ＜ 0.05 ].Pathological chianges of glomeruli,renal interstitium and interstitum vascular were found in MHT IgA nephropathy.According to Lee classificntion,the pathological classifications more than grades Ⅲ account for 100.0％ (12/12) in MHT IgA nephropathy,while 46.7％ ( 7/15 ) in non-MHT IgA nephropathy group ( P ＜0.01 ).Conclusions Renal lesion in IgA nephropathy with MHT and AKI is serious and the prognosis is worse.The prognosis may depend on duration,serum creatinine level at the time of biopsy,the degree of pathological damage and whether antihypertensive treatment reaches standards.
Keywords：IgA nephropathyHypertensionmalignantClinicPathologyAnalysisPrognosis
Publication Date：2012-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)