Could mesangial C3 deposition be an independent prognostic marker in immunoglobulin A nephropathy?

Autor: Cetinkaya H; Department of Nephrology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. drhcetinkaya@gmail.com., Gursu M; Medical Faculty, Nephrology, Bezmialem Vakif University, Istanbul, Turkey., Yazici H; Istanbul Medical Faculty, Nephrology, Istanbul University, Istanbul, Turkey., Cebeci E; Department of Nephrology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Eren N; Medical Faculty, Nephrology, Kocaeli University, Izmit, Kocaeli, Turkey., Altiparmak MR; Cerrahpasa Medical Faculty, Nephrology, Istanbul University, Istanbul, Turkey., Akcay OF; Medical Faculty, Nephrology, Gazi University, Ankara, Turkey., Sahin G; Department of Nephrology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Dheir H; Medical Faculty, Nephrology, Sakarya University, Adapazari, Sakarya, Turkey., Basturk T; Department of Nephrology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Atilgan KG; Department of Nephrology, Diskapi Training and Research Hospital, University of Health Sciences, Ankara, Turkey., Aydemir N; Department of Nephrology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey., Turgutalp K; Division of Nephrology, Department of Internal Medicine, Mersin University School of Medicine, Mersin, Turkey., Yilmaz M; Department of Nephrology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Sirali SK; Department of Nephrology, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey., Tatar E; Department of Nephrology, Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey., Boz EG; Division of Nephrology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey., Mirioglu S; Medical Faculty, Nephrology, Bezmialem Vakif University, Istanbul, Turkey., Kazan S; Department of Nephrology, Afyonkarahisar School of Medicine, University of Health Sciences, Afyonkarahisar, Turkey., Aydin E; Medical Faculty, Nephrology, Dicle University, Diyarbakir, Turkey., Aydin Z; Department of Nephrology, Darica Farabi Training and Research Hospital, University of Health Sciences, Darica, Kocaeli, Turkey., Turkmen K; Meram Medical Faculty, Nephrology, Necmettin Erbakan University, Konya, Turkey., Kutlay S; Medical Faculty, Nephrology, Ankara University, Ankara, Turkey., Karagoz F; Medical Faculty, Nephrology, Trakya University, Edirne, Turkey., Ogutmen MB; Department of Nephrology, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Ozturk S; Istanbul Medical Faculty, Nephrology, Istanbul University, Istanbul, Turkey., Ozkan O; Department of Nephrology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Yildiz N; Medical Faculty, Nephrology, Kocaeli University, Izmit, Kocaeli, Turkey., Dincer T; Cerrahpasa Medical Faculty, Nephrology, Istanbul University, Istanbul, Turkey., Yasar E; Medical Faculty, Nephrology, Gazi University, Ankara, Turkey., Gok M; Department of Nephrology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Turkmen A; Istanbul Medical Faculty, Nephrology, Istanbul University, Istanbul, Turkey., Dede F; Department of Nephrology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey., Derici U; Medical Faculty, Nephrology, Gazi University, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Journal of nephrology [J Nephrol] 2024 May; Vol. 37 (4), pp. 923-932. Date of Electronic Publication: 2023 Nov 10.
DOI: 10.1007/s40620-023-01770-1
Abstrakt: Background: Immunoglobulin A nephropathy (IgAN) is a common primary glomerulonephropathy. There is evidence that mesangial C3 deposition plays a role in the development of the disease. The aim of this study was to examine the effect of C3 deposition on the prognosis of IgAN patients.
Method: The study included 1135 patients with biopsy-confirmed IgAN from the database of the Turkish Nephrology Association Glomerular Diseases Working Group (TSN-GOLD). Patients were excluded from the study if they were aged < 18 or > 75 years or if C3 staining had not been performed in the immunofluorescent analysis. C3 deposition was defined as an immunofluorescence intensity of C3 ≥ 2 + within the mesangium. The primary endpoints were the development of end-stage renal disease, a 30% decrease in glomerular filtration rate compared to the basal value or an elevation in proteinuria to a nephrotic level (3.5 gr/day).
Results: Mesangial C3 deposition was observed in 603 (53.1%) patients. No statistically significant difference was found at baseline between the groups with and without mesangial C3 deposition, as for age, sex, BMI, proteinuria level, or the presence of hypertension. In the follow-up period with a mean duration of 78 months, no significant difference was found between the two groups regarding the primary endpoints (p = 0.43). A significant correlation between C3 deposition and segmental glomerulosclerosis (S1) according to the Oxford MEST-C classification was found (p = 0.001).
Conclusion: Although a correlation was observed between mesangial C3 deposition and the S1 MEST-C classification, mesangial C3 deposition was not a prognostic factor in IgAN.
(© 2023. The Author(s) under exclusive licence to Italian Society of Nephrology.)
Databáze: MEDLINE
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