Extraglomerular C3 deposition and metabolic impacts in patients with IgA nephropathy

    loading  Checking for direct PDF access through Ovid

Abstract

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.

Related Topics

    loading  Loading Related Articles