Abstract: Objective To investigate the influence of hyperlipidemia on clinical and pathological characteristics of mild to moderate proteinuria patients with IgA nephropathy.Methods A total of 529mild to moderate proteinuria patients with IgA nephropathy were selected and divided into hyperlipidemia group and normal lipid group according to serum lipid level.The clinical manifestations and pathological differences were analyzed and compared between two groups.The clinical and pathological characteristics of patients with different levels of urinary protein were compared as well.Results Compared with the normal serum lipid group,body mass index in patients with hyperlipidemia group (BMI),systolic blood pressure,diastolic blood pressure,uric acid (UA),24 h urinary protein significantly increased,while tubular atrophy,interstitial fibrosis,renal interstitial inflammatory cell infiltration degree were heavy (P ＜ 0.05).Pearson correlation analysis showed that hyperlipidemia group total cholesterol (CHOL) and 24 h urinary protein and systolic pressure was positively correlated with serum albumin (ALB).Triglyceride (TG) and 24 h urinary protein,BMI and estimated glomerular filtration rate (eGFR) were positively correlated.High density lipoprotein cholesterol (HDL) was negatively correlated with BMI,ALB,UA and diastolic blood pressure.In patients with2 4 h urinary protein in 1 to 3.5 g,2 3 9 patients (7 6.6 ％) had hyperlipidemia,and compared with normal blood lipid,the BMI,systolic blood pressure,diastolic blood pressure,UA,2 4 h urinary protein significantly increased,while mesangial proliferation,mesangial cell hyperplasia were severe (P ＜0.05).In patients with 24 h urinary protein less than 1 g,132 patients had hyperlipidemia (60.7％),and compared with the normal blood lipids,the BMI and UA were elevated,smoking and drinking were common,and the degree of interstitial fibrosis was serious (P ＜0.05).Conclusion The BMI,blood pressure,UA,24 h urinary protein significantly increase in patients with hyperlipidemia,and renal tubular atrophy,interstitial fibrosis,renal interstitial inflammatory cell infiltration are more severe.In the patients with 24 h urinary protein in 1 to 3.5 g,the incidence rate of hyperlipidemia is higher than that in the patients with 24 h urinary protein less than 1 g.