Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the clinical and pathological characteristics of IgA nephropathy (IgAN)patients with gross hematuria and acute renal injury (AKI),and factors affecting recovery of renal function.
Ｍｅｔｈｏｄｏｌｏｇｙ：From December 2001 to February 2018, 30 cases of primary IgAN patients with gross hematuria and AKI (AKI group) were included in our hospital, and 60 cases of IgAN patients with gross hematuria but without AKI (nonAKI group) were randomly selected. Clinical and pathological data of two groups were compared.
Ｒｅｓｕｌｔｓ：(1) There were significant differences between AKI group and nonAKI group in age≥55 years, duration of hematuria≥10 days, baseline serum creatinine (SCr), albumin, and 24-hour urine protein (P<0.05). Renal tubular atrophy, interstitial cell infiltration, and renal arteriosclerosis were more serious in AKI group. Risk factors of AKI in IgAN patients with gross hematuria included duration of gross hematuria≥15 days, and massive 24-hour urine protein. (2)23.3％ of AKI patients failed to fully recovery of renal function after treatment. There were significant differences in age,duration of gross hematuria, baseline SCr, score of glomerulosclerosis and renal tubular atrophy between partial and complete renal function recovery groups. By multivariate Logistic regression analysis, baseline eGFR was found to be the independent risk factor of recover of renal function.
Ｃｏｎｃｌｕｓｉｏｎ：The duration of gross hematuria≥15 days and proteinuria were the risk factors of AKI in IgAN patients.Sustained gross hematuria, elderly age, high basal creatinine, decreased basal eGFR, and severe glomerulosclerosis and tubular atrophy are risk factors for incomplete recovery of renal function after AKI.

Key words: IgA nephropathy, macroscopic haematuria, acute kidney injury, risk factors