Gonadotropin releasing hormone antagonist（Gn RH-A） directly inhibits gonadotropin（Gn） secretion by binding to gonadotropin releasing hormone（Gn RH） receptor competitively. Antagonists can be administered once or many times.Many clinical applications have been explored. Antagonists can combine with clomiphene, aromatase inhibitor or human menopausal gonadotropin and so on. Antagonist has been widely used because of its advantages such as reducing the occurrence of ovarian hyperstimulation syndrome, reducing the dosage of gonadotropin, and being suitable for a wide population. However it may lead to a low pregnancy rate in fresh cycle transplantation. This article aims to review the application and research progress of antagonists in assisted reproduction.

IgA nephropathy (IgAN) is characterized by deposition of galactose-deficient IgA1 (Gd-IgA1) in glomerular mesangium associated with mucosal immune disorders. Since environmental pollution has been associated with the progression of chronic kidney disease in the general population, we specifically investigated the influence of exposure to fine particulate matter less than 2.5 μm in diameter (PM2.5) on IgAN progression. Patients with biopsy-proven primary IgAN were recruited from seven Chinese kidney centers. PM2.5 exposure from 1998 to 2016 was derived from satellite aerosol optical depth data and a total of 1,979 patients with IgAN, including 994 males were enrolled. The PM2.5 exposure levels for patients from different provinces varied but, in general, the PM2.5 exposure levels among patients from the north were higher than those among patients from the south. The severity of PM2.5 exposure in different regions was correlated with regional kidney failure burden. In addition, each 10 μg/m3 increase in annual average concentration of PM2.5 exposure before study entry (Hazard Ratio, 1.14; 95% confidence interval, 1.06-1.22) or time-varying PM2.5 exposure after study entry (1.10; 1.01-1.18) were associated with increased kidney failure risk after adjustment for age, gender, estimated glomerular filtration rate, urine protein, uric acid, hemoglobin, mean arterial pressure, Oxford classification, glucocorticoid and renin-angiotensin system blocker therapy. The associations were robust when the time period, risk factors of cardiovascular diseases or city size were further adjusted on the basis of the above model. Thus, our results suggest that PM2.5 is an independent risk factor for kidney failure in patients with IgAN, but these findings will require validation in more diverse populations and other geographic regions.

目的 探讨血清抑制素B(INHB)在促性腺激素释放激素拮抗剂(GnRH-A)方案中的动态变化及对体外受精-胚胎移植(IVF-ET)结局预测价值.方法 回顾性分析2018年10月-2020年9月于苏州大学附属第一医院生殖中心首次接受GnRH-A方案的81例患者临床资料,收集月经第2或3天(Db)、Gn第5或6天(DGn)、使用GnRH-A 2 d后(DGnRH-A)、HCG日(DHCG)的血清INHB水平.将38例行新鲜周期胚胎移植的患者分为ET妊娠组(n=17)和ET未妊娠组(n=21);将71例进行胚胎移植(新鲜周期和/或冷冻周期)的患者分为总妊娠组(n=40)和总未妊娠组(n=31).10例患者未行胚胎移植,其中4例患者无可移植胚胎,6例患者在观察期内因个人原因未行胚胎移植.观察INHB的动态变化及与IVF-ET结局参数的相关性,比较各妊娠分组中血清INHB水平.结果 Db、DGn、DGnRH-A、DHCG的血清INHB水平呈现先上升后下降的趋势,INHB与Gn用量存在明显负相关(P<0.05);与大中卵泡数(直径≥14 mm)、成熟卵泡数(直径≥18 mm)、DHCG-E2、获卵数、2PN受精卵数、2PN卵裂数及胚胎数存在正相关(P<0.05);均与优质胚胎数无明确相关性.ET妊娠组中DGnRH-A-INHB水平低于ET未妊娠组,总妊娠组和总未妊娠组INHB水平比较,差异无统计学意义(P>0.05).结论 在GnRH-A方案促排卵过程中,血清INHB水平呈现先上升后下降的动态变化,血清INHB水平对卵巢功能、卵母细胞及胚胎数量存在一定的预测价值,其中加入GnRH-A后的血清INHB水平对新鲜周期胚胎移植妊娠结局可能存在预测价值.

We aimed to validate three IgAN risk models proposed by an international collaborative study and another CKD risk model generated by an extended CKD cohort with our multicenter Chinese IgAN cohort. Biopsy-proven IgAN patients with an eGFR ≥15 ml/min/1.73 m2 at baseline and a minimum follow-up of 6 months were enrolled. The primary outcomes were a composite outcome (50% decline in eGFR or ESRD) and ESRD. The performance of those models was assessed using discrimination, calibration, and reclassification. A total of 2,300 eligible cases were enrolled. Of them, 288 (12.5%) patients reached composite outcome and 214 (9.3%) patients reached ESRD during a median follow-up period of 30 months. Using the composite outcome for analysis, the Clinical, Limited, Full, and CKD models had relatively good performance with similar C statistics (0.81, 0.81, 0.82, and 0.82, respectively). While using ESRD as the end point, the four prediction models had better performance (all C statistics > 0.9). Furthermore, subgroup analysis showed that the models containing clinical and pathological variables (Full model and Limited model) had better discriminatory abilities than the models including only clinical indicators (Clinical model and CKD model) in low-risk patients characterized by higher baseline eGFR (≥60 ml/min/1.73 m2). In conclusion, we validated recently reported IgAN and CKD risk models in our Chinese IgAN cohort. Compared to pure clinical models, adding pathological variables will increase performance in predicting ESRD in low-risk IgAN patients with baseline eGFR ≥60 ml/min/1.73 m2.

目的 探讨人工肝血浆置换治疗重型肝炎效果及其预后影响因素.方法 选取2017年10月—2020年10月收治的重型肝炎102例,按照治疗方法不同将其分为研究组(70例)和对照组(32例)两组.比较两组治疗3个月后临床效果、治疗前和治疗3个月后肝功能指标,观察两组治疗期间不良反应发生情况,并采用单因素和多因素Logistic回归分析探讨影响重型肝炎预后的相关因素.结果 治疗3个月后,临床有效率研究组为95.71％高于对照组68.75％,差异有统计学意义(P<0.01).治疗3个月后,两组总胆红素(TBIL)和结合胆红素(DBIL)均较治疗前降低,白蛋白(ALB)和凝血酶原活动度(PTA)均较治疗前升高;研究组TBIL和DBIL低于对照组,ALB和PTA高于对照组,差异有统计学意义(P<0.01).治疗期间,研究组发生低血压、发热反应和四肢麻木各1例,对照组发生恶心和呕吐1例.单因素分析结果显示,预后良好组和预后不良组临床分期、治疗方法,TBIL、DBIL、ALB、PTA、血白细胞、血肌酐水平,以及是否并发感染、肝性脑病比较差异有统计学意义(P<0.01).多因素Logistic回归分析结果显示,内科常规治疗、PTA<60％、血肌酐≥120μmol/L和并发肝性脑病为影响重型肝炎预后的独立危险因素(P<0.01).结论 人工肝血浆置换治疗重型肝炎患者临床效果好,可改善肝功能,且安全性佳.内科常规治疗、PTA<60％、血肌酐≥120μmol/L和并发肝性脑病为影响重型肝炎预后的独立危险因素.

Background: Diabetic encephalopathy is a severe diabetes complication with cognitive dysfunction and neuropsychiatric disability. The mechanisms underlying diabetic encephalopathy is believed to be relevant with oxidative stress, vascular amylin deposition, immune receptors, inflammation, etc. This study wanted to evaluate the ability of curcumin and its analog A13 to alleviate oxidative stress and inflammation in diabetes-induced damages in brain. Methods: Sixty adult male Sprague-Dawley rats were divided into 5 groups: normal control (NC) group, diabetes mellitus (DM) group, curcumin-treated diabetes mellitus (CUR) group, high dose of A13-treated diabetes mellitus (HA) group, low dose of A13-treated diabetes mellitus (LA) group. Activation of the nuclear factor kappa-B (NF-κB p65) pathway was detected by RT-qPCR, immunohistochemical (IHC) staining and Western blot; oxidative stress was detected by biochemical detection kit; brain tissue sections were stained with hematoxylin–eosin (HE) staining and Myelin staining. Results: RT-qPCR, IHC staining and Western blot showed that curcumin and A13 treatment could inhibit the NF-κB p65 pathway. Curcumin and A13 increased the activity of superoxide dismutase and decreased the malondialdehyde level in the brain of diabetic rats. Furthermore, HE staining and Myelin staining demonstrated that the histological lesions of the brain in diabetic rats could be significantly ameliorated by curcumin and A13. Conclusion: Curcumin analog A13 could alleviate the damages in the brain of diabetes rats by regulating the pathways of inflammation and oxidative stress. A13 may be a new potential therapeutic agent for diabetic encephalopathy.

There were few related studies aiming to severe IgA nephropathy (IgAN) which could progress rapidly to end stage renal disease (ESRD) within ten years. To find valuable clinical or pathological factors and promising precautions is essential.

The renal prognosis and treatment of primary IgA nephropathy (IgAN) patients with segmental glomerular necrosis (SGN) remain controversial. Patients with primary IgAN confirmed by renal biopsy were enrolled. Patients with SGN on renal biopsy were selected as the necrosis group, and a propensity score matching method was used to match a control group according to age, gender, weight, height and follow-up time. A total of 825 IgAN patients were enrolled in the present study. Seventy-three (8.8%) patients with SGN were selected as the necrosis group, and 292 patients without SGN were matched as the control group. Compared to the control group, a significantly increased serum fibrinogen level (3.97 g/L vs 3.54 g/L, P=.002) and proportion of patients with macroscopic hematuria (35.6% vs 14.7%, P<.001) was observed in the necrosis group. According to the new IgA pathological classification system, crescent formation was more pronounced in the necrosis group (P=.001). The average estimated glomerular filtration rate was obviously higher in the necrosis group and decreased more slowly during follow-up. However, the time-averaged urine protein-to-creatinine ratio remained low in the necrotic group, whereas it gradually increased in the control group. SGN suggests an active renal inflammatory state, but it was not an independent risk factor for a poor renal outcome in patients treated with immunosuppressive therapy. Furthermore, patients with SGN had a more stable renal function and low urinary protein excretion during follow-up, which may be attributable to aggressive immunotherapy.

BACKGROUNDThe clinical course of immunoglobulin A (IgA) nephropathy (IgAN) is highly variable, making it difficult to predict which patients are at risk for rapid progression. The aim of this study was to develop and validate a kidney failure risk prediction equation for adults with IgAN.STUDY DESIGNMulticenter retrospective cohort study of 2,155 Chinese patients with IgAN.CANDIDATE PREDICTORSClinical and histology variables.OUTCOMESTime to end-stage renal disease (ESRD).ANALYTICAL APPROACHThe association of baseline predictors with the outcome was tested using cause-specific hazards models by treating death as a censoring event.RESULTSThe discovery cohort was composed of 934 IgAN cases with a mean follow-up of 56.3 months. The independent validation cohort was composed of 1,221 additional patients with a mean follow-up of 47.8 months. There were 212 ESRD events in the combined cohort. The best clinical predictive model of ESRD included 5 variables: age, sex, estimated glomerular filtration rate, hemoglobin concentration, and urine protein excretion. The best model combining clinical and histologic data included 2 clinical variables (age and estimated glomerular filtration rate) and 2 pathology scores (M and T scores from the Oxford classification). Both models predicted ESRD well at 10 years in the validation cohort (C statistics of 0.86 [95% CI, 0.83-0.90] and 0.83 [95% CI, 0.77-0.89], respectively). Continuous net reclassification index and integrated discrimination improvement indicated superior performance of the new models compared with previously published models. The performance of the new clinical model was similar to that of the new model that incorporated histologic variables.LIMITATIONSRetrospective study design, differences in severity of disease between the discovery and validation cohorts, the competing risk of death, lack of validation in ethnically diverse patients.CONCLUSIONSKidney failure risk in the setting of IgAN is able to be predicted in a Chinese population using clinical and histologic variables. Additional evaluation of these equations needs to be implemented in more ethnically diverse patients before they can be applied to clinical practice broadly.

IgA nephropathy (IgAN) is an autoimmune disease associated with complement activation. It is unclear whether the ratio of serum C3 and C4 concentrations (C3/C4 ratio) can predict renal outcomes in IgAN patients. A total of 1503 patients diagnosed with IgAN via renal biopsy were recorded in this study. Poor renal outcomes were defined as > 50% decrease in the baseline estimated glomerular filtration rate (eGFR) or development of end-stage renal disease (ESRD) during follow-up. In total, 712 patients meeting the exclusion/inclusion criteria were selected, and the mean follow-up period was 40.6 (12.34) months. Patients with decreased C3/C4 ratios displayed significantly more severe clinical characteristics and renal pathological features and a higher proportion of poor renal outcomes and ESRD. The optimal multivariate Cox regression models identified the C3/C4 ratio (hazard ratio (HR) 0.63, 95% CI 0.5–0.9), serum uric acid (HR 1.58, 95% CI 1.2–2.2), serum creatinine (HR 1.3, 95% CI 1.1–1.6), systolic blood pressure (HR 1.57, 95% CI 1.2–2.0) and T score (relative to T0, T1: HR 1.96, 95% CI 1.1–3.7, T2: HR 3.03, 95% CI 1.6–5.9) as strong predictors of poor renal outcomes. Subgroup analysis showed that patients with low C3/C4 ratios benefited from glucocorticoids or other immunosuppressive agents (hazard ratio 0.30 and 0.18, 95% CI 0.13–0.72 and 0.07–0.46, respectively). Serum C3/C4 ratios may be an independent novel predictor of renal outcomes in IgAN patients. Decreased C3/C4 ratios suggest poor renal outcomes and the potential to benefit from aggressive immunosuppressive therapies.

[Objective] To discuss the relationship between Serum FGF21 and diabetic nephropathy (DN) .[Method] 150 pa-tients with DN were selected from CKD 1 to 5 stage as Group A and every stage includes 30 patients .50 cases patients with type II diabetes but not with DN as group B .Group C includes 50 volunteers of healthy physical examination .The expression of serum FGF 21 was determined by enzyme-linked immune sorbent assay (ELISA) .Then the clinicaland laboratory data were collected .The association between DN and FGF21was analyzed .[Result](1) compared with group B and group C ,levels of serum BUN、Scr、UA and age、high blood pressure ,family history of CVD were obviously increase in group A ( P< 0 .001 ) , but HDL-CH in group A is obviously decrease ( P<0 .001 ) .Compared with group B ,creatinine clearance rate (Ccr )in group A is obviously decrease and 24-hour urine protein quantitation is obviously increase ( P<0 .001 ) .The blood concentrations of FGF21among three groups is significant difference ( P< 0 .05 ) ,FGF21 concentrations of group A significantly higher than the other two groups .(2) With the progress of kidney disease from stage I to V ,the blood concentration of serum FG F 2 1 gradu-ally increased ( P< 0 .05) .(3)Result of Pearson correlation analysis indicated that serum FGF21 level of group A was positive-ly correlated with age ,Body Mass Index ,FBG ,creatinine ,urea nitrogen and triglyceride ( P< 0 .05 ) ,and was negatively correlated with HDL-CH ( P< 0 .05 ) .[Conclusion] In patients with type 2 diabetic nephropathy FGF21 serum concentration&nbsp;increased significantly .With the progress of the kidney disease ,FGF21 concentration has increased trend .It indicated FGF21 have a certain correlation with diabetic nephropathy ,FGF21 may participate in the occurrence and the progress of diabetic nephropathy.

目的:评价骨化三醇不同给药方案对血液透析患者矿物质及骨代谢紊乱(CKD-MBD)及FGF23的影响.方法:选取血甲状旁腺素(PTH)水平在300～ 621 pg/ml(正常的4～9倍)之间的血液透析患者,随机分成骨化三醇常规治疗组(常规组,22例)和间歇给药组(间歇组,26例),疗程16周,检测治疗前后血清FGF-23水平、钙磷代谢等指标变化.结果:(1)两组患者治疗终点与治疗前比较,血PTH均明显下降、血维生素D及FGF23均明显升高(P＜0.05).间歇组在治疗终点,血钙明显升高、碱性磷酸酶明显下降(P＜0.05),而持续组,治疗前后血钙、碱性磷酸酶无明显变化.(2)在不同治疗时间点,持续组PTH明显下降(P＜0.05);间歇组PTH、碱性磷酸酶明显下降,血钙明显升高(P＜0.05).治疗第4周、第8周,间歇组PTH下降较持续组明显(P＜0.05).(3)治疗期间,持续组有6例患者血磷升高,间歇组无血磷升高患者.治疗期间无高钙血症发生.结论:骨化三醇不同给药方案能不同程度下降患者血PTH、升高FGF23,间歇组较持续组明显;间歇给药组血钙明显升高、碱性磷酸酶明显下降.两组治疗方案均能改善继发性甲状旁腺功能亢进,间歇给药组降PTH效果更佳.骨化三醇治疗轻中度继发性甲状旁腺功能亢进安全有效.

BACKGROUND:To compare the Na/H2O and urea removal between residual renal function (RRF) and peritoneal clearance (PC) in peritoneal dialysis patients. Try to explore the difference between RRF and PC in prognosis of chronic kidney disease patients who need peritoneal dialysis (PD) treatment.METHODS:Weekly Na/H2O and urea removal by PC and RRF were investigated individually. Independent samples t-test was carried out to compare the efficiency of removal between RRF and PC treatment. Pearson correlated analysis was applied to reveal the relationship between Na/H2O and urea removal and Kt/V.RESULTS:Although a higher Na/H2O removal rate by RRF was showed in this investigation, the difference was not statistical significant compared to the one by PC. On the other hand, urea removal by RRF was obviously higher than PC. For every 0.1 Kt/V, Na/H2O removal by RRF was distinctly higher than PD. The Na and H2O removal of RRF were 147.88 ± 83.72 mmol and 46.54 ± 39.11 mmol, respectively; and the ones of PD were 11.40 ± 6.08 mmol and 4.47 ± 4.79 mmol. By using statistical assay, the correlations relevance between Na/H2O removal and Kt/V in RRF were showed stronger than in PC. However, the total removal of Na/H2O showed a poor correlation with Kt/V in both RRF and PC.CONCLUSIONS:The removal efficiency of RRF is much higher than PC. This study suggests that it is important to adjust dialysis program when RRF gets declined. Also the correlation between Na/H2O removal rate and Kt/V is an important monitoring factor for the patients who are receiving peritoneal dialysis.

Background: The purpose of this study was to investigate the cancer incidence in patients with end-stage aristolochic acid nephropathy (AAN). Methods: A total of 102 patients with end-stage AAN treated in our hospital between 2004 and 2013 were included in this study. The correlation of cancer incidence with age, gender, dosage of aristolochic acid (AA), the type of renal replacement therapies, and the polymorphisms of quinone oxidoreductase 1 (NQO1) C609T and cytochrome P450 1A1 (CYP1A1) A4889G was examined. Results: The cancer incidence rate in our patients was 41.2% (42 in 102) including 39 cases of urinary cancer. The mortality rate in the patients with cancer was significantly higher than that in the patients without cancer (31%, 13/42 vs. 11.7%, 7/60, p<0.05). Thirteen patients developed cancer before entering end-stage renal disease (ESRD). Cancer incidence was significantly associated with the dosage of AA consumption (p = 0.091). Hemodialysis, peritoneal dialysis and renal transplant did not affect the cancer incidence in our patients differently, but appeared to be associated with cancer at particular locations of urinary system. The patients undergoing hemodialysis seemed to more likely have bladder cancer (72.72%), while the patients receiving peritoneal dialysis appeared to develop cancer predominantly in the upper urinary tract (66.67%). Conclusions: The cancer initiation in our patients seems significantly correlate with the dosage of AA consumption. Different renal replacement therapies appear to be associated with cancer at particular locations of urinary system in our patients.

Objective To investigate the pathogens and their antibiotic resistance in patients with peritoneal dialysis (PD)- related peritonitis. Methods One hundred and nine episodes of PD- related peritonitis from 74 PD patients were treated at De-partment of Nephrology, the First Affiliated Hospital of Wenzhou Medical Col ege from January 2008 to December 2010. Causative organisms, antibiotic sensitivity and effectiveness of the empirical treatment protocol were retrospectively analyzed. Results Total 103 strain pathogens were isolated:Gram- positive organisms caused 69 episodes peritonitis (67.0%), gram- neg-ative organisms caused 27 episodes(26.2%), fungi caused 7 episodes peritonitis (6.8%), 21 cases were culture- negative. Coag-ulase- negative staphylococcus (30, 29.1%), especial y Staphylococcus epidermidis (17, 16.5%) was the most common gram- positive pathogen. Escherichia coli was the most common gram- negative pathogen(13, 12.6%). Resistant rate of S. aureus to cefazolin was 100.0%. Resistant rate of Escherichia coli to ceftazidime was 20.0%. There was no significant difference in cure rate between empirical treatment protocol including cefazolin group and that including vancomycin group (P>0.05). There was also no significant difference in cure rate between empirical treatment protocol including ceftazidime group and that including levoflocaxin/amikacin group(P>0.05). Conclusion Gram- positive bacteria, especial y S. epidermidis are the main causative or-ganisms of PD- related peritonitis in our center. Cefazolin is unsuitable as an empirical antibiotic for al patients. Gram- negative organisms can be treated by ceftazidime, levoflocaxin or amikacin.

Objective To investigate the infection rates of mycoplasma penetrans (Mpe),mycoplasma pneumoniae (Mp) and mycoplasma ferments (Mf) in patients with IgA nephropathy (IgAN),chronic kideny disease (CKD),and heathy people,to compare the difference of infection rate,and to analyze the association of mycoplasma infection and clinicopathological features in IgAN.Methods Blood samples were collected from 118 patients in IgAN group,90 patients in CKD group,and 89 cases in health control group.DNA of Mpe,Mp and Mf was detected in plasma by PCR.Positive cases were confirmed by Southern blot.According to mycoplasma infection,IgAN patients were divided into two groups,then analyzed the clinicopatholgical features.Results (1)Genus,Mpe,Mp,and Mf positive rates were 33.05％,16.1％,25.45 ％,and 8.47％ in IgAN group,respectively; 5.56％,2.22％,5.56％,and 2.22％ in CKD group,respectively; and 3.33 ％,1.11％,2.22％,and 0 in health group,respectively.Compared with CKD and health group,patients in IgAN group had a higher infection rate in Genus,Mpe,and Mp (P ＜ 0.05).In IgAN group,10 patients had three kinds of mycoplasmas infection at the same time,and positive rate was 8.47％ much higher than CKD group (positive rate was 2.22％) (P ＜ 0.05).(2) Based on mycoplasm detection results,IgAN patients were divided into two groups,overlapping infection group and mycoplasma negative group.In overlapping infection group,the mean age of onset was much younger than negative group.Compared with negative group,overlapping infection group had higher tonsillitis and urinary tract infection rate,more severe microscopic hematuria and tubulointerstitium lesion (P ＜ 0.05).Conclusions Patients with IgAN had higher infection rate of Genus,Mpe and Mp,compared with CKD patients and health people.Compared with mycoplasma negative group in IgAN patients,more severe microscopic hematuria and tubulointerstitium lesion in overlapping infection group,which suggested that infection of Mpe might have some possible connection with IgAN.

Objective: To investigate the relationship between serum and urine neutrophil gelatinase - associated lipocalin ( sNGAL and uNGAL) level and clinical and pathological features of IgA nephropathy( IgAN) . Methods: 40 cases of biopsy proven IgAN patients at first onset without glucocorticoids and/or immunosuppresants therapy were enrolled in the study. 10 healthy persons matched in age and sex were selected as a control. The clinical and pathological data were collected. The sNGAL and uNGAL were measured by enzyme linked immunosorbent assay. The kidney pathological score were evaluated with IgAN Oxford classification crite- ria and Katafuchi semi - quantitation criteria. The relationship between sNGAL and uNGAL and clinical and pathological features of IgAN were analysed. Results: sNGAL and uNGAL were more sensitive on reflecting renal function than serum creatinine( Scr) and blood urea nitrogen( BUN) in IgAN patients. The correlation analysis in clinical and pathological index such as hypertension,Scr, BUN,mesangial proliferation( M) ,interstitial fibrosis,renal tubule atrophy( T) on Oxford criteria and mesangial proliferation,focal segmental lesion,global sclerosis,inflammatory cell infiltration,interstitial fibrosis,tubule atrophy on Katafuchi semi - quantitation criteria had significant differences statistically ( P 0. 05,partly P 0. 01) ,especially in renal tubule and interstitial lesion including inflammatory cell infiltration,interstitial fibrosis and tubule atrophy( correlation coefficient 0. 6,P 0. 01) . Receiver operating characteristic( ROC) indicated that sNGAL and uNGAL were more sensitive than Scr and eGFR on reflecting the pathological damage in renal tubule and interstitium,while sNGAL was a more sensitive and specific than uNGAL. Conclusion: sNGAL and uNGAL were closely related with clinical and pathological features of IgA nephropathy. sNGAL and uNGAL were more sensitive and specific on re- flecting the clinical and pathological lesions in IgAN ,especially in renal tubule and interstitium. sNGAL and uNGAL could be sensi- tive markers to evaluate renal damage in IgA nephropathy.