Severe glomerular C3 deposition indicated severe renal lesions and poor
prognosis in patients with Immunoglobulin A Nephropathy
Abstract
ABSTRACT Background and objectives Glomerular C3 deposition is often
observed in renal biopsies of patients with IgA nephropathy (IgAN),
however, the relationship between the level of C3 deposition and the
long-term prognosis of IgAN have rarely been reported. In this
observational cohort study, we aimed to evaluate the prognostic value of
glomerular C3 deposition in the progression of IgAN. Materials and
Methods From June 2009 to June 2010, a total of 136 adult patients with
IgAN were enrolled in the study. Glomerular deposition of the complement
protein C3, immune complexes, and inflammatory cells were detected in
renal biopsy tissue. The level of renal lesions, glomerular immune
complexes, and the density of interstitial inflammatory cells were
analyzed. Based on an average of 105 months of follow-up, the predictive
value of glomerular C3 deposition for IgAN progression was investigated.
Results Of the 136 patients, 102 patients were classified into the
glomerular C3low group and 34 patients were classified into the
glomerular C3high group. Patients in C3high group had more immune
complexes deposition than those in C3low group. In C3high group, the
degree of renal lesion and interstitial fibrosis were severer compared
to C3low group. Renal biopsy in C3high group presented with higher
density of interstitial inflammatory cells that in C3low group. The
density of glomerular C3 deposition was associated with poor renal
survival over a 105-month follow-up. Conclusions The high density of
glomerular C3 deposition was associated with severity of renal lesions
and predicted a long-term poor renal survival for IgAN patients.