Extraglomerular C3 deposition and metabolic impacts in patients with IgA nephropathy
| Autor: | Satoshi Horikoshi, Hiroyuki Ohi, Masaya Ishii, Hiroyuki Inoshita, Kisara Onda, Seiji Nagamachi, Hiyori Suzuki, Azusa Hashimoto, Isao Ohsawa, Yasuhiko Tomino, Nobuyuki Sato, Gaku Kusaba, Mamiko Shimamoto |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Urinary system Renal function Gastroenterology Group A Group B Nephropathy Immunoenzyme Techniques Risk Factors Internal medicine medicine Humans Transplantation medicine.diagnostic_test business.industry Glomerulonephritis IGA Complement C3 Prognosis medicine.disease Glomerular Mesangium Surgery Blood pressure Nephrology Disease Progression Female Renal biopsy business Body mass index Biomarkers Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Nephrology Dialysis Transplantation. 28:1856-1864 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/gfs262 |
| Popis: | Background. The aim of the present study was to explore the significance of extraglomerular (Bowman’s capsule and/or arteriole) C3 (ex-C3) deposits in IgA nephropathy (IgAN). Methods. One hundred and seventy patients with IgAN were divided into two groups: Group A (n = 79), patients who did not have ex-C3 deposits, and Group B (n = 91), patients who had ex-C3 deposits. Results. At the time of renal biopsy, Group B was characterized by a marked increase in diastolic blood pressure, total cholesterol, triglyceride and low-density lipoprotein-cholesterol compared with those of Group A. After 4 years, the estimated glomerular filtration rate (eGFR) in Group B was significantly worse than that of Group A. Upon examination by electron microscopy, the arteriolar dense deposits in Group B were found to occur in significantly higher amounts than in Group A. One hundred and thirty-four patients underwent a 3-year follow-up study after intervention and were re-divided by therapeutic factors as follows: ‘conventional therapy’, treatment with anti-hypertensive drugs and/or anti-platelet drugs, and ‘aggressive therapy’, additional treatment with either tonsillectomy or corticosteroid. Patients treated with conventional therapy in Group B had significantly higher body mass index and levels of C3 and CH50 compared with other Groups. Aggressive therapy was significantly effective in urinary protein reduction in both Group A and Group B. Except for the patients who received aggressive therapy in Group A, the levels of the eGFR gradually declined. Conclusions. It appears that IgAN patients who have ex-C3 deposits have worse clinical outcomes. |
| Databáze: | OpenAIRE |
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