Objective:To evaluate the risk factors and the prognosis of IgA nephropathy(IgAN)with hyperu-ricemia(HUA).Method:A total of 471 patients diagnosed with IgAN by renal biopsy from 2014-01 to 2022-05 were recruited.They were divided into HUA group(n=278)and normal uric acid(NUA)group(n=193)based on uric acid(UA)levels.The clinical and pathological characteristics of both groups were compared,and logistic regression analysis was used to identify the risk factors in IgAN patients with HUA.Based on endpoint events of a 50％decline in estimated glomerular filtration rate(eGFR),doubling of serum creatinine(Scr)level,or end-stage renal disease(ESRD)during the follow-up period(median follow-up time 50.4 months),Cox proportional-hazards analysis was used to analyze the risk factors of poor prognosis in IgAN patients with HUA and Kaplan-Meier surviv-al curves was used to compare the renal survival rate in two groups.Results:The proportion of hypertension,Scr,24h urine total protein(UTP),triglyceride(TG)levels,tubular atrophy/interstitial fibrosis(T1-T2)and cellular/fi-brous crescent(C1-C2)were higher in the HUA group than in the NUA group,while albumin(Alb)was lower than in the NUA group(P＜0.05 or P＜0.01).Logistic regression analysis showed that UTP(OR:1.231;95％CI:1.042-1.454,P＜0.05),hypertension(OR:1.884;95％CI:1.143-3.104,P＜0.05)and Scr(OR:1.018;95％CI:1.006-1.030,P＜0.05)were risk factors in IgAN patients with HUA.During the follow-up period,15.92％of patients had an endpoint event,which was higher in the HUA group(14.44％)than in the NUA group(1.49％)(x2=5.16,P＜0.01).Cox regression analysis suggested that UTP(HR:1.192;95％CI:1.051-1.352,P＜0.01)and hypertension(HR:3.186;95％CI:1.757-5.776,P＜0.01)were independent risk factors of poor prognosis in patients of IgAN with HUA.The Kaplan-Meier survival curve suggested that renal survival rate was lower in HUA group than NUA group(92.68％vs 97.92％,x2=12.35,P＜0.01).Conclusion:The risk factors in IgAN patients with HUA should be actively intervened to improve the prognosis of patients.
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