دانلودمقاله باموضوع طولانی مدت-کلیه-بقا-در-آنتی نوتروفیل-سیتوپلاسمی-مورچه-2021_کلیه-اینتر
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موضوع به انگلیسی:Long-Term Renal Survival in Antineutrophil
Cytoplasmic Antibody–Associated
Glomerulonephritis With Complement C3
Deposition
بخشی از متن:Introduction: Recent studies have revealed the pivotal role of complement activation in the pathogenesis
of antineutrophil cytoplasmic antibody–associated glomerulonephritis (ANCA-GN). This study investigated
the clinicopathologic and prognostic significance of glomerular C3 deposition in the renal histopathology
of patients with ANCA-GN.
Methods: We retrospectively identified 142 patients with ANCA-GN from 6 hospitals in Japan (2004–2020).
C3 deposition was defined as C3 staining $1þ on a scale of 0 to 2þ using direct immunofluorescence (IF).
The primary composite end points included a 30% reduction in estimated glomerular filtration rate (eGFR),
end-stage kidney disease (ESKD), and death. We compared clinicopathologic features and long-term
outcomes between patients with and without C3 deposition.
Results: C3 deposition was observed in 56 of 142 kidney biopsy samples (39.4%). Patients with C3
deposition had a lower serum C3 level (P ¼ 0.002). During a median follow-up of 2.9 (interquartile range:
0.2–5.7) years, 69 events occurred and the cumulative event-free survival rate at 5 years was significantly
lower in the C3-positive group than in the C3-negative group (log-rank: P ¼ 0.002). In multivariable analysis,
C3 deposition was significantly associated with the composite end points after adjusting for age, sex,
baseline eGFR, serum C3 level, treatment, and the percentage of normal glomerulus, cellular crescents,
global sclerosis, and interstitial damage (adjusted hazard ratio [HR] ¼ 2.02, 95% confidence interval: 1.20–
3.40, P ¼ 0.008
