Publication:
Clinical significance of glomerular C3 deposition in primary membranous nephropathy

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2021-01-01T00:00:00Z
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Oto, Özgür Akın
Demir, Erol
Mirioğlu, Şafak
Dirim, Ahmet Burak
Özlük, Mesude Yasemin
Cebeci, Egemen
Baştürk, Taner
Uçar, Ali Rıza
Soltanova, Lala
Nuriyev, Kanan
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Abstract
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.
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Oto Ö. A. , Demir E., Mirioğlu Ş., Dirim A. B. , Özlük M. Y. , Cebeci E., Baştürk T., Uçar A. R. , Soltanova L., Nuriyev K., et al., -Clinical significance of glomerular C3 deposition in primary membranous nephropathy-, JOURNAL OF NEPHROLOGY, 2021
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