上海交通大学学报（医学版）

上海交通大学学报（医学版）

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IgA肾病进展至终末期肾病临床预测的研究现状

周悦玲1，蒋更如2   

  1. 1.上海交通大学 医学院， 上海 200025； 2.上海交通大学 医学院附属新华医院肾脏风湿免疫科， 上海 200092
  • 出版日期:2016-02-28 发布日期:2016-03-29
  • 通讯作者: 蒋更如, 电子信箱: jianggeng-ru@hotmail.com。
  • 作者简介:周悦玲（1989—）， 女， 博士生; 电子信箱: stellabright@163.com。

Research progresses of clinical prediction of development of IgA nephropathy towards end-stage renal disease

ZHOU Yue-ling1, JIANG Geng-ru2   

  1. 1.Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2.Department of Nephrology and Rheumatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2016-02-28 Published:2016-03-29

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摘要：

IgA肾病（IgAN）是目前全球最常见的原发性肾小球肾炎，其病程极具多样性， 15%~40%的患者在确诊后10~20年逐渐进展至终末期肾病（ESRD）。研究显示，IgAN在亚洲地区的发病率远高于北美、欧洲等地，亚裔患者更易进展至ESRD，该疾病目前已成为导致亚裔人群发生ESRD的首要原发性肾小球疾病。蛋白尿、肾小球滤过率估算值下降、肾脏严重病理损伤、高血压、低白蛋白血症、高尿酸血症、贫血等是导致IgAN患者发生ESRD的危险因素，其他因素如男性、血尿、不良生活方式等尚存在争议。同时，研究人员建立了多种评估该病进展至ESRD风险的预测模型，包括Goto模型、Utsunomiya模型、Berthoux模型、瑞金医院模型等，为早期预测及干预提供了可能。

关键词: IgA肾病, 终末期肾病, 危险因素, 肾脏累积生存率

Abstract:

IgA nephropathy (IgAN) is the most common primary glomerulonephritis in the world with a highly variable course. About 15% to 40% of patients will progressively develop to end-stage renal disease (ESRD) within 10 to 20 years after diagnosis. Many studies indicate that the incidence of IgAN in Asia is higher than that in North America and Europe. Asian patients are more likely to develop to ESRD and IgAN has become the principal primary glomerulonephritis leading to ESRD in Asian population. Risk factors that cause the incidence of ESRD of patients with IgAN include proteinuria, decline of estimated glomerular filtration rate, severe histopathological injury, hypertension, hypoalbuminemia, hyperuricemia, and anemia. Other factors such as male gender, hematuria, and unhealthy lifestyles are controversial. Meanwhile, researchers have established various models for predicting the risk of this disease to develop to ESRD, including Goto model, Utsunomiya model, Berthoux model, and Ruijin Hospital model, etc, which provide the possibility for early prediction and intervention.

Key words: IgA nephropathy, end-stage renal disease, risk factor, cumulative renal survival