ĐÁNH GIÁ NỒNG ĐỘ ACID URIC MÁU Ở BỆNH NHÂN VIÊM THẬN LUPUS VÀ MỘT SỐ YẾU TỐ LIÊN QUAN

Abstract

Objectives: Investigating levels of acid uric in patients with lupus nephritis and the relationship between hyperuremia and some clinical, subclinical factors in this patient group. Subjects and methods: A cross-sectional, retrospective and prospective study on 117 lupus nephritis patients treated in Nephro – Urology and Dialysis Center, Bach Mai hospital from 01/2020 to 08/2021. Results: 117 study patients have an average age of 34.6 ± 1.11, with a male: female ratio of 1:9.64, and 35.9% of patients have detected the disease in 1 month. The rate of hyperuricemia accounted for 75.2%, the average concentration was 463.60 ± 13.03. The rate of increased uric acid in women was higher than in men, with statistical significance (p<0.01) although uric acid levels in the two sexes were not different (p>0.05). Symptoms such as pericardial effusion (57.7%), hypertension (56.4%), nephrotic syndrome (57.3%), anemia (87.2%) had a statistically significant difference between the 2 groups of hyperuricemia acid and non-hyperuricemia (p<0.05). On kidney biopsies in 46 patients, the rate of class III, IV was 30.6%, 61.1%, average uric acid concentration: 415.18±102.025 and 503.76±105.190, there was a statistically significant difference with p=0.019. Uric acid has a positive correlation with systolic blood pressure, pulmonary arterial pressure, creatinine, ferritin, anti-ANA, proteinuria with r = 0.188; 0.242; 0.476; 0.265; 0.206; 0.226 (p<0.05) and negatively correlated with glomerular filtration rate, urinary pH, hemoglobin, protein, C3 with r = -0.457; -0.241; -0.204, -0.261, -0.331 (p<0.05). Uric acid and disease activity levels based on the SLEDAI scale have positively correlated with the correlation coefficient r = 0.388 (p<0.001). Uric acid levels in patients with pulmonary arterial hypertension >40mmHg higher than non-pulmonary arterial hypertension: 560.1±173.03; 464.3 ± 131.31 with p<0.05. Conclusions: Increased uric acid was found in 75.2% of patients with lupus nephritis, predicting poor progression of lupus nephritis and complications of the disease (lower eGFR, more anemia, increased blood pressure, higher SLEDAI disease activity levels…) Keeping uric acid levels low is recommended to help avoid complications in lupus nephritis and serum uric acid levels should be adopted in medical practice when evaluating patients with lupus nephritis.