Clinical significance of glomerular C3 deposition in primary membranous nephropathy


Oto Ö. A. , Demir E., Mirioğlu Ş. , Dirim A. B. , Özlük M. Y. , Cebeci E., ...Daha Fazla

JOURNAL OF NEPHROLOGY, cilt.34, sa.2, ss.581-587, 2021 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Konu: 2
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1007/s40620-020-00915-w
  • Dergi Adı: JOURNAL OF NEPHROLOGY
  • Sayfa Sayıları: ss.581-587

Özet

Background We aimed to investigate the effects of glomerular C3 deposition on clinical, histopathological features, and outcomes of patients with primary membranous nephropathy (MN). Methods A total of 261 patients with biopsy-proven primary MN, who were on follow up for at least 6 months, were included in the study. The patients were grouped according to their C3 immunostaining in kidney biopsy samples at the time of diagnosis: Low intensity [LI; (C3 1 +)] and high intensity [HI; (C3 2 + or C3 3 +)]. The primary outcome was the development of kidney failure. Complete (CR) or partial remission (PR) was defined as secondary outcome. Results Sixteen patients reached the primary outcome after a median follow-up of 33.8 months. Patients in the high intensity group (119 cases) had lower eGFR and higher proteinuria at admission and last follow-up compared to patients in the low intensity group (142 cases). Also, more patients in the high intensity group reached the primary outcome compared to patients in the low intensity group: twelve patients (10.1%) in the high intensity group and four patients (2.8%) in the low intensity group reached the primary outcome (p = 0.015). Kaplan-Meier analysis demonstrated that patients in the high intensity group had a higher risk for kidney failure (p = 0.02). In multivariate logistic regression analysis, high intensity C3 deposition and initial estimated glomerular filtration rate (eGFR) indepenently predicted primary outcome. Conclusion Extensive glomerular C3 deposition is a predictor of kidney failure in patients with MN.