Ｏｂｊｅｃｔｉｖｅ：To investigate the incidence of cholesterol crystals (CCs) in renal tubular lumen in IgA nephropathy (IgAN),and the effect of CCs in renal tubular lumen on the prognosis of IgAN.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 5 025 native renal biopsies were observed routinely from Mar. 2019 to Dec. 2019 for the incidence of CCs.  3 784 IgAN patients from 2006 to 2010 and 20182019 were retrospectively observed,and 147 patients with CCs in renal tubular lumen were finally included in the study. The control group comprised of 446 patients of IgAN without CCs. Clinical,pathological and prognosis of the patients were collected and analyzed.
Ｒｅｓｕｌｔｓ：The total incidence of renal tubular lumen CCs in different renal diseases was 068%(34/5 025). The incidence of renal tubular lumen CCs in IgAN was 145% (25/1 718). The level of urine protein,serum creatinine,total cholesterol,triglyceride,uric acid in study group were all higher than those in  control group. Mesangial proliferation,segmental sclerosis,and tubulointerstitial damage in study group were more severe than those in control group. Survival analysis showed that  renal prognosis of  study group was significantly worse than that of control group (P<0001). Multivariate COX regression model analysis found that  presence of CCs,hypercholesterolemia,and impaired renal function at the time of biopsy were independent risk factors for renal prognosis in patients with IgAN.
Ｃｏｎｃｌｕｓｉｏｎ：The incidence of CCs in renal tubular lumen in IgAN is higher than other kidney diseases. The clinical and pathological manifestations of IgAN with CCs were more severe,and prognosis was poorer than those without CCs.