1.The relationships of hyperuricemia with clinical and Oxford classiifcations in children with IgA nephropathy
Yang LIU ; Jinfeng WEI ; Xuemei ZHOU ; Changchun LI ; Zhihao ZHANG ; Fagui HE
Journal of Clinical Pediatrics 2016;34(6):411-413
Objective To investigate the relationships of hyperuricemia with clinical and Oxford classifications in children with IgA nephropathy.Methods Clinical data of 213 children with IgA nephropathy were retrospective analyzed. According to the levels of blood uric acid, these children were divided into two groups, hyperuricemia group (n?=?51) and normal uric acid group (n?=?162). Differences of clinical index and Oxford classiifcation between the two groups were observed. Results The 24 h urinary protein, level of serum creatinine, glomerular ifltration rate (eGFR) in hyperuricemia group were signiifcantly higher than those in normal group (P all?0.05). Oxford classiifcation showed that the degree of mesangial cell proliferation (M1) and renal tubular atrophy/interstitial ifbrosis (T1-2) in hyperuricemia group were more serious than in normal uric acid group (P all?0.01).Conclusions Children with IgA nephropathy combined with hyperuricemia were worse in clinical index and pathological manifestations. Increased serum uric acid may be one of the important factors that contribute to poor prognosis of children with IgA nephropathy.
2.Clinical analysis in patients with rhabdomyolysis and acute kidney injury caused by intense exercise
Qingying FU ; Rui LIU ; Fagui HE ; Fujun SHAN ; Lu MA
Chinese Journal of Postgraduates of Medicine 2018;41(10):904-908
Objective To investigate the clinical features of patients with rhabdomyolysis and acute kidney injury (AKI) caused by intense exercise. Methods Data on patients with rhabdomyolysis and AKI due to intense military exercise from January 2002 to December 2017 in a single Chinese nephrology center were retrospectively reviewed. Parameters included clinical manifestations, markers of renal function and muscle damage, treatment and prognosis. Results Twenty-two male servicemen with AKI caused by rhabdomyolysis were included. They took part in the military running training before onset. 95.5%(21/22) took part in 5-kilometer race, of which cross-country was 86.4%(19 cases) and bare-handed was 9.1%(2 cases). Most cases occurred in summer, in which 72.7%(16 cases) took part in 5-kilometer cross-country race. The levels of serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA) and creatine kinase (CK) significantly increased in patients, with 9.1%(2 cases) reaching AKI stage 1, 31.8% (7 cases) reaching AKI stage 2, and 59.1% (13 cases) reaching AKI stage 3, respectively. Serum CK levels were positively correlated with AKI stage (r=0.453, P<0.05), Scr (r=0.494, P<0.05) and BUN (r=0.545, P<0.01), while negatively correlated with UA (r=-0.487, P<0.05). Serum LDH levels were positively correlated only with age (r=0.533, P<0.05). Serum UA presented inverse correlations with BUN (r=- 0.513, P<0.05), K+ (r=- 0.642, P<0.01) and CK (r=- 0.487, P<0.05), and positive correlation with age (r=0.431, P<0.05). In particular, duration from onset of disease had a stronger positive association with BUN (r=0.907, P<0.01) and Scr (r=0.690, P<0.01). Of these patients with AKI, 21 cases(95.5%) reached complete recovery of kidney function and 1 case (4.5%) changed to chronic renal failure within 3 months after comprehensive treatments , including 8 cases(36.4%) who received appropriate continuous venovenous hemofiltration. Conclusions Intense exercise in summer is likely to cause rhabdomyolysis and AKI. Early diagnosis and comprehensive treatment including appropriate blood purification are crucial for a successful treatment. Our findings also emphasize the importance of age on muscle injury and the monitoring of electrolysts, markers of muscle damage and renal function for prevention of rhabdomyolysis and its related complications.