title: Clinicopathological features and risk factors analysis of IgA nephropathy associated with acute kidney injury.
abstract: OBJECTIVE
  The aim of this work is to investigate the distinctive clinicopathological characteristics of AKI in Chinese IgAN population and possible risk factors for AKI.
  
  
  METHODS
  We performed a retrospective analysis of 1512 patients with biopsy-proven primary IgAN in the period 2006 through 2011 in The First Affiliated Hospital of Sun Yat-sen University. AKI was defined as 2012 KDIGO (Kidney Diseases: Improving Global Outcomes) criteria, and the patients were divided into AKI group (n = 145) and non-AKI group (n = 1367).
  
  
  RESULTS
  The prevalence of AKI of the IgAN patients in our center was 9.59% (145/1512). Most AKI patients were older age, male, with higher percentage of smoke, hypertension, hyperlipidemia and preexisting impaired kidney function (Scr > 133 μmol/L), and higher serum creatinine, proteinuria, uric acid, whilst less onset of macroscopic hematuria as well as lower serum albumin and hemoglobin (p < 0.05). The pathological features were much more severe in AKI group as well. Acute tubulointerstitial nephritis was found as the most predominant pathological change of intrinsic AKI in our IgAN population instead of macroscopic hematuria associated acute tubular injury/necrosis. In multivariate logistic regression analysis, we found that older age, male gender, malignant hypertension, proteinuria, cellular crescent, fibrocellular crescent, glomerular sclerosis ≥ 50% were possible risk factors for AKI.
  
  
  CONCLUSIONS
  AKI is commonly seen among IgAN population. The clinicopathological features are much more severe in IgAN patients with AKI. Useful clinicopathological predictors are recognized to improve the identification of IgAN patients who are at high risk for AKI.
authors.affiliation: a Department of Nephrology , The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health , Guangzhou , PR China ;
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: a Department of Nephrology , The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health , Guangzhou , PR China ;
authors.forename: Jianbo
authors.initials: J
authors.lastname: Li
authors.affiliation: b Department of Pathology , The First Affiliated Hospital, Sun Yat-sen University , Guangzhou , PR China ;
authors.forename: Shicong
authors.initials: S
authors.lastname: Yang
authors.affiliation: a Department of Nephrology , The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health , Guangzhou , PR China ;
authors.forename: Naya
authors.initials: N
authors.lastname: Huang
authors.affiliation: c Epidemiology Research Unit, Translational Medicine Research Center, The First Affiliated Hospital, Sun Yat-sen University , Guangzhou , PR China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: a Department of Nephrology , The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health , Guangzhou , PR China ;
authors.forename: Qiongqiong
authors.initials: Q
authors.lastname: Yang
authors.affiliation: a Department of Nephrology , The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health , Guangzhou , PR China ;
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D000328:Adult; D001706:Biopsy / Q000379:methods; D003404:Creatinine / Q000032:analysis; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods; D007678:Kidney Glomerulus / Q000473:pathology / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D013223:Statistics as Topic
chemical_list: D003404:Creatinine
keywords: Acute kidney injury; IgA nephropathy; acute tubulointerstitial nephritis; macroscopic hematuria; risk factor