To investigate the impact of different types of dyslipidemia on clinical and pathological characteristics of IgA nephropathy (IgAN).

A total of 283 patients with primary IgAN were enrolled. The clinical and pathological data of all the patients were recorded and retrospectively analyzed. The patients were divided into normal blood lipid group, hypercholesterolemia (H-TC)group, hypertriglyceridemia (H-TG) group, and low high density lipoprotein (L-HDL) group.The general information, and clinical and pathological features of IgAN were compared. And stepwise regression analysis method for multiple linear regression analysis was used to investigate the influence factors of estimated glomerular filtration rate (eGFR) of the patients.

Compared with the normal blood lipid group, the H-TC group had higher 24-hour urinary protein excretion (Z=-2.979, P=0.003) and lower plasma albumin (t=2.606, P<0.001). The H-TG group also had higher body mass index (BMI)(t=-3.982, P<0.001), higher serum uric acid (t=3.982, t=5.056, P<0.001), and lower eGFR (t=2.011, P=0.045) than the normal blood lipid group. The L-HDL group had higher BMI (t=-2.946, P=0.004), lower eGFR (t=2.498, P=0.013), and more serious renal tubular atrophy /interstitial fibrosis than the normal blood lipid group (χ²=8.284, P<0.017). The regression equation results indicated that the age, systolic blood pressure, uric acid (P<0.05), and serum TC (95%CI: -5.228 to -0.312, t=-2.220, P=0.027) were negatively associated with eGFR. The serum HDL was positively correlated with eGFR (95%CI: 1.469 to 7.468, t=2.935, P=0.004). The model was statistically significant (F=11.838, P<0.001).

Hypercholesterolemia, hypertriglyceridemia, and low high density lipoprotein all could do harm to the clinical outcomes of IgAN patients. The renal tubulointerstitial damage was worse in IgAN patients with low high density lipoprotein. Decreasing the serum total cholesterol level and increasing the serum high density lipoprotein level might help to improve the outcomes of IgAN patients.