Objective: To analyze the characteristics of vascular lesions and their influencing factors in IgA nephropathy (IgAN).
Methods: The clinical and pathologic materials of 1,005 IgAN patients were analyzed.
Results: Of the 1005 IgAN patients 54.6% were with vascular lesions. The patients with vascular lesions were older, underwent renopuncture earlier, and had a longer duration of disease than those without vascular lesions (all P < 0.01). The patients with severe vascular lesions were older and underwent renopuncture at older age in comparison with those with mild vascular lesions (P < 0.05 and P < 0.01). The patients with moderate vascular lesions had a longer course than those with mild lesions (P < 0.01). The systolic pressure and diastolic pressure of patients with severe, moderate, and mild vascular lesions were higher than those in patients without vascular lesions (all P < 0.01). The systolic pressure and diastolic pressure were significantly higher in the patients with severe vascular lesions than in those with mild vascular lesions (P < 0.01 and P < 0.05). The serum triglyceride level was significantly higher in the patients with severe, moderate, and mild vascular lesions than in those without vascular lesions (all P < 0.01). The serum triglyceride level was significantly higher in the patients with severe vascular lesions than in those with mild vascular lesions (P < 0.01). The levels of urine protein of all patients with vascular lesions were significantly higher than that of those without vascular lesions (all P < 0.01). The urine protein level was significantly higher in the patients with severe vascular lesions than in those with moderate and mild vascular lesions (both P < 0.01). The serum creatinine was higher in all patients with vascular lesions than in those without vascular lesions (all P < 0.01) and was significantly higher in the patients with severe and moderate vascular lesions than in those with mild vascular lesions (P < 0.05 and P < 0.01). The blood albumin level was significantly lower in all patients with vascular lesions than that in those without vascular lesions (all P < 0.01). The higher the pathological grade of the nephropathy, the more severe the vascular lesion (P < 0.01). The C3 deposition along the interstitial vascular wall was more severe in those with vascular lesions than in those without vascular lesions (P < 0.01). Multivariate logistic regression analysis showed that the significant influencing factors on vascular lesions included hypertension, high serum uric acid, global glomerular sclerosis (>or= 50%), interstitial inflammation (>or= 50%) and pathological grade III-V.
Conclusion: In patients with IgAN, vascular lesion parallels the blood pressure, serum triglyceride, urine protein, serum creatinine, etc. It reflects the disease degree and can be used as an important histological prognostic indicator.