RESUMEN
BACKGROUND: Immunoglobulin A nephropathy (IgAN) is a common primary glomerulonephropathy. There is evidence that mesangial C3 deposition plays a role in the development of the disease. The aim of this study was to examine the effect of C3 deposition on the prognosis of IgAN patients. METHOD: The study included 1135 patients with biopsy-confirmed IgAN from the database of the Turkish Nephrology Association Glomerular Diseases Working Group (TSN-GOLD). Patients were excluded from the study if they were aged < 18 or > 75 years or if C3 staining had not been performed in the immunofluorescent analysis. C3 deposition was defined as an immunofluorescence intensity of C3 ≥ 2 + within the mesangium. The primary endpoints were the development of end-stage renal disease, a 30% decrease in glomerular filtration rate compared to the basal value or an elevation in proteinuria to a nephrotic level (3.5 gr/day). RESULTS: Mesangial C3 deposition was observed in 603 (53.1%) patients. No statistically significant difference was found at baseline between the groups with and without mesangial C3 deposition, as for age, sex, BMI, proteinuria level, or the presence of hypertension. In the follow-up period with a mean duration of 78 months, no significant difference was found between the two groups regarding the primary endpoints (p = 0.43). A significant correlation between C3 deposition and segmental glomerulosclerosis (S1) according to the Oxford MEST-C classification was found (p = 0.001). CONCLUSION: Although a correlation was observed between mesangial C3 deposition and the S1 MEST-C classification, mesangial C3 deposition was not a prognostic factor in IgAN.
RESUMEN
BACKGROUND: Indications of dialysis treatment for patients with end-stage renal disease depend on various clinical and laboratory parameters. In this study, we aimed to determine whether standardized serum cystatin C (SCC) equation may be an applicability of marker for dialysis initiation and its relationship to other clearance values among patients with advanced chronic kidney disease. MATERIALS AND METHODS: A total of 84 patients (45 males, 39 females) aged 19-89 were evaluated in this study. Hemodialysis was indicated according to clinical and laboratory findings, and estimated glomerular filtration rate (eGFR) was according to four different formulas [MDRD, EpiCKD, Cockcroft Gault formula (CGF) and SCC equation]. RESULTS: eGFR values of patients in the study were 7.23 ± 3.26, 7.86 ± 3.78, 15.09 ± 10.88 and 11.31 ± 4.54 according to MDRD, EpiCKD, SCC equation and CGF, respectively. There was a positive correlation between MDRD, EpiCKD and CGF, and between EpiCKD and CGF (p < 0.01). Also, statistically significant correlation was found between SCC equation and CGF (p < 0.05). CONCLUSION: SCC equation was not seemed to be an appropriate marker for starting dialysis in patients with advanced CKD.
