Extraglomerular C3 deposition and metabolic impacts in patients with IgA nephropathy.
Nephrol Dial Transplant
; 28(7): 1856-64, 2013 Jul.
Article
em En
| MEDLINE
| ID: mdl-22773242
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complemento C3
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Biomarcadores
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Mesângio Glomerular
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Glomerulonefrite por IGA
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article