Publication:
C3 deposits worsens the prognosis in type iii extracapillary glomerulonephritis.

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2017-10-05

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Sánchez-Agesta Martínez, Marina
Rabasco Ruiz, Cristina
Sánchez Sánchez, Rafael
Ortega Salas, Rosa
López Andreu, María
Aljama García, Pedro
Espinosa Hernández, Mario

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Abstract

Type iii extracapillary glomerulonephritis (PEGN) is a common cause of rapidly progressive glomerulonephritis and it is usually associated with circulating anti-neutrophil cytoplasmic antibodies (ANCAs). Recent evidence points to complement activation as an important factor in the pathogenesis of PEGN. The aim of the present study was to assess the value of C3 deposits in the prognosis of PEGN. All patients diagnosed of PEGN from 1995 to 2015 (n=72) were included in this study. Progression of renal disease in patients with positive staining for C3 by immunofluorescence was compared with those with negative staining. Mean follow up was 73 months. Progression to end-stage renal disease in relation to clinical and histological variables was analyzed. Positive staining for C3 was observed in 22 out of the 72 patients (30.5%). At the time of diagnosis, patients with C3 deposits had higher serum creatinine concentration than those without C3 staining (5.00 vs. 3.85mg/dl, P=0.050). Renal survival at 10 years was 36.9% in patients with positive C3 staining vs. 64.4% in patients with negative staining (P=0.005). Mortality at 10 years was higher in patients with C3 deposits than in patients without deposits (77 vs. 49.3%). Thus, our study shows that PEGN with deposits of C3 is associated with worse renal prognosis and greater mortality. These results would support the hypothesis that activation of the alternative pathway complement may play an important role in the generation of renal injury associated with PEGN.

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Aged
Antibodies, Antineutrophil Cytoplasmic
Biomarkers
Complement C3
Creatinine
Female
Glomerulonephritis
Humans
Kaplan-Meier Estimate
Kidney
Male
Middle Aged
Prognosis
Proportional Hazards Models
Renal Dialysis
Retrospective Studies

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Keywords

C3 deposits, Complement, Complemento, Crescents, Depósitos de C3, Extracapillar glomerulonephritis, Glomerulonefritis extracapilar, Semilunas

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