The prognostic role of activation of the complement pathways in the progression of advanced IgA nephropathy to end-stage renal disease.
C1q
C3
Complement system
Factor B
IgA nephropathy
Prognosis
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
30 Oct 2024
30 Oct 2024
Historique:
received:
02
04
2024
accepted:
21
10
2024
medline:
31
10
2024
pubmed:
31
10
2024
entrez:
31
10
2024
Statut:
epublish
Résumé
The role of complement system in late stage of IgA nephropathy (IgAN) remains unknown. We therefore investigated the effects of complement system on worsening kidney function in advanced (stage 4 CKD) IgAN. Renal specimens of 69 IgAN patients who underwent renal biopsy during stage 4 CKD between 2010 and 2021, were stained using immunofluorescence (IF) and immunohistochemistry (IHC) for glomerular complement components. The primary outcome was progression to end-stage renal disease (ESRD). Associations of complement components with baseline clinicopathological characteristics and outcomes were assessed using multivariable Cox regression and Spearman analyses. During a median follow-up of 18.0 months, 26 (37.7%) patients progressed to ESRD and none died. C1q and C3 deposition were detected in 12 and 66 patients, respectively. Higher eGFR [hazards ratio (HR), 0.852, 95% confidence interval (CI), 0.756-0.959; P = 0.008], higher C3 intensity (HR, 2.955, 95%CI, 1.063-8.220; P = 0.038) and T1-2 score (HR, 2.576, 95%CI, 1.205-5.576, P = 0.015) were predictive of time to ESRD in CKD 4 stage IgAN. Significant expressions of C1q (P = 0.005), C4d (P < 0.001), factor B (P < 0.001), C3 (P = 0.042) and C5b-9 (P = 0.004) were identified in ESRD group than in non-ESRD group by IHC, while MBL expression was low. Although they were not associated with baseline 24 h-UP, higher factor B and C1q expressions were both correlated with a lower baseline eGFR (P < 0.001 and = 0.04, respectively) and the deterioration of kidney function during follow-up (P = 0.046 and 0.015, respectively). Complement deposition in IgAN patients with stage 4 CKD portends a faster deterioration of kidney function. Activation of classical and alternative complement pathways plays a major role in this stage.
Identifiants
pubmed: 39478440
doi: 10.1186/s12882-024-03832-3
pii: 10.1186/s12882-024-03832-3
doi:
Substances chimiques
Complement C1q
80295-33-6
Complement C3
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
387Subventions
Organisme : China Postdoctoral Science Foundation
ID : 2023M733986, 2023T160741
Organisme : China Postdoctoral Science Foundation
ID : 2023M733986, 2023T160741
Organisme : China Postdoctoral Science Foundation
ID : 2023M733986, 2023T160741
Organisme : China Postdoctoral Science Foundation
ID : 2023M733986, 2023T160741
Organisme : China Postdoctoral Science Foundation
ID : 2023M733986, 2023T160741
Organisme : China Postdoctoral Science Foundation
ID : 2023M733986, 2023T160741
Organisme : China Postdoctoral Science Foundation
ID : 2023M733986, 2023T160741
Organisme : cross-sectional project of China-Japan Friendship Hospital
ID : 2023-HX-JC-10
Organisme : cross-sectional project of China-Japan Friendship Hospital
ID : 2023-HX-JC-10
Organisme : cross-sectional project of China-Japan Friendship Hospital
ID : 2023-HX-JC-10
Organisme : cross-sectional project of China-Japan Friendship Hospital
ID : 2023-HX-JC-10
Organisme : cross-sectional project of China-Japan Friendship Hospital
ID : 2023-HX-JC-10
Organisme : cross-sectional project of China-Japan Friendship Hospital
ID : 2023-HX-JC-10
Organisme : cross-sectional project of China-Japan Friendship Hospital
ID : 2023-HX-JC-10
Organisme : International Association of Chinese Nephrologists Research Grant
ID : IACNRG-01
Organisme : International Association of Chinese Nephrologists Research Grant
ID : IACNRG-01
Organisme : International Association of Chinese Nephrologists Research Grant
ID : IACNRG-01
Organisme : International Association of Chinese Nephrologists Research Grant
ID : IACNRG-01
Organisme : International Association of Chinese Nephrologists Research Grant
ID : IACNRG-01
Organisme : International Association of Chinese Nephrologists Research Grant
ID : IACNRG-01
Organisme : International Association of Chinese Nephrologists Research Grant
ID : IACNRG-01
Informations de copyright
© 2024. The Author(s).
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