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Predictive value of mesangial C3 and C4d deposition in IgA nephropathy

Title
Predictive value of mesangial C3 and C4d deposition in IgA nephropathy
Authors
Nam, Ki HeonJoo, Young SuLee, ChanghyunLee, SangmiKim, JoohwanYun, Hae-RyongPark, Jung TakChang, Tae IkRyu, Dong-RyeolYoo, Tae-HyunChin, Ho JunKang, Shin-WookJeong, Hyeon JooLim, Beom JinHan, Seung HyeokKorean GlomeruloNEphritis STudy Ko
Ewha Authors
류동열
SCOPUS Author ID
류동열scopus
Issue Date
2020
Journal Title
CLINICAL IMMUNOLOGY
ISSN
1521-6616JCR Link

1521-7035JCR Link
Citation
CLINICAL IMMUNOLOGY vol. 211
Keywords
C3C4dComplementIgA nephropathy
Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
We aimed to determine the relative contribution of each complement (C3 and C4d) deposition to the progression of IgA nephropathy (IgAN). We enrolled a total of 380 patients with biopsy-confirmed IgAN. Mesangial deposition of C3( < 2+ vs. >= 2 + ) and C4d(positive vs. negative) was evaluated by immunofluorescence staining and immunohistochemistry, respectively. Study endpoint was the composite of a 30% decline in eGFR or ESRD. The risk of reaching the primary outcome was significantly higher in patients having C3 >= 2+ and C4d( + ) than in corresponding counterparts. Adding C3 deposition to clinical data acquired at kidney biopsy modestly increased the area under the receiver-operating characteristic curve, net reclassification improvement, and integrated discrimination improvement (IDI); adding C4d increased IDI only. In conclusion, mesangial C3 and C4d deposition was an independent risk factor for progression of IgAN. C3 showed better predictability than C4d, suggesting that lectin pathway alone has limited clinical prognostic value.
DOI
10.1016/j.clim.2019.108331
Appears in Collections:
의과대학 > 의학과 > Journal papers
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