Correlation of arteriolar hyalinosis and clinicopathological features in patients with IgA nephropathy and hypertension

To explore the differences in clinical indicators and clinicopathological characteristics immunoglobulin A nephropathy (IgAN) patients with hypertension accompanied with arteriolar hyalinosis and those without.

A total of 246 patients who was diagnosed with biopsy-proven primary IgAN and hypertension in our hospital from 2012 to 2018 were enrolled in our study. According to the severity of arteriolar hyalinosis, they were divided into 3 groups, without (n=73) and with mild (n=136, severity: 1%~25%) and moderate arteriolar hyalinosis (n=37, severity: 26%~50%), respectively. The correlations of clinicopathological parameters with arteriolar hyalinosis were analyzed in the groups.

The incidence (55.3%) of mild arteriolar hyalinosis was the highest in the patients. There were significant differences in tumor necrosis factor-α (TNF-α), urea, serum creatinine (Scr), uric acid, and estimated glomerular filtration rate (eGFR) among the 3 groups (P<0.05). In clinicopathological parameters, glomerulosclerosis, mesangial hypercellularity (M), segmental sclerosis (S), and interstitial fibrosis/tubular atrophy (T) lesions and grades of Lee classification differed statistically among the 3 groups (P<0.05). Moreover, correlation analysis showed that arteriolar hyalinosis had a strong positive correlation with grade of Lee classification (r_s=0.433, P<0.001), Scr (r_s=0.319, P<0.001) and T (V=0.317, P<0.001), respectively, while a strong negative correlation with eGFR (r_s=-0.367, P<0.001).

Significant differences are observed in clinical and pathological indicators in patients with IgAN and hypertension accompanied with arteriolar hyalinosis or not. Its severity is closely associated with renal function, so arteriolar hyalinosis can be used as an indicator to evaluate the function.