Serum C3/C4 ratio is a novel predictor of renal prognosis in patients with IgA nephropathy: a retrospective study

Serum C3/C4 ratio is a novel predictor of renal prognosis in patients with IgA nephropathy: a... IgA nephropathy (IgAN) is an autoimmune disease associated with complement activation. It is unclear whether the ratio of serum C3 and C4 concentrations (C3/C4 ratio) can predict renal outcomes in IgAN patients. A total of 1503 patients diagnosed with IgAN via renal biopsy were recorded in this study. Poor renal outcomes were defined as > 50% decrease in the baseline estimated glomerular filtration rate (eGFR) or development of end-stage renal disease (ESRD) during follow-up. In total, 712 patients meeting the exclusion/inclusion criteria were selected, and the mean follow-up period was 40.6 (12.34) months. Patients with decreased C3/C4 ratios displayed significantly more severe clinical characteristics and renal pathological features and a higher proportion of poor renal outcomes and ESRD. The optimal multivariate Cox regression models identified the C3/C4 ratio (hazard ratio (HR) 0.63, 95% CI 0.5–0.9), serum uric acid (HR 1.58, 95% CI 1.2–2.2), serum creatinine (HR 1.3, 95% CI 1.1–1.6), systolic blood pressure (HR 1.57, 95% CI 1.2–2.0) and T score (relative to T0, T1: HR 1.96, 95% CI 1.1–3.7, T2: HR 3.03, 95% CI 1.6–5.9) as strong predictors of poor renal outcomes. Subgroup analysis showed that patients with low C3/C4 ratios benefited from glucocorticoids or other immunosuppressive agents (hazard ratio 0.30 and 0.18, 95% CI 0.13–0.72 and 0.07–0.46, respectively). Serum C3/C4 ratios may be an independent novel predictor of renal outcomes in IgAN patients. Decreased C3/C4 ratios suggest poor renal outcomes and the potential to benefit from aggressive immunosuppressive therapies. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Immunologic Research Springer Journals

Serum C3/C4 ratio is a novel predictor of renal prognosis in patients with IgA nephropathy: a retrospective study

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Publisher
Springer US
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Allergology; Immunology; Medicine/Public Health, general; Internal Medicine
ISSN
0257-277X
eISSN
1559-0755
D.O.I.
10.1007/s12026-018-8995-6
Publisher site
See Article on Publisher Site

Abstract

IgA nephropathy (IgAN) is an autoimmune disease associated with complement activation. It is unclear whether the ratio of serum C3 and C4 concentrations (C3/C4 ratio) can predict renal outcomes in IgAN patients. A total of 1503 patients diagnosed with IgAN via renal biopsy were recorded in this study. Poor renal outcomes were defined as > 50% decrease in the baseline estimated glomerular filtration rate (eGFR) or development of end-stage renal disease (ESRD) during follow-up. In total, 712 patients meeting the exclusion/inclusion criteria were selected, and the mean follow-up period was 40.6 (12.34) months. Patients with decreased C3/C4 ratios displayed significantly more severe clinical characteristics and renal pathological features and a higher proportion of poor renal outcomes and ESRD. The optimal multivariate Cox regression models identified the C3/C4 ratio (hazard ratio (HR) 0.63, 95% CI 0.5–0.9), serum uric acid (HR 1.58, 95% CI 1.2–2.2), serum creatinine (HR 1.3, 95% CI 1.1–1.6), systolic blood pressure (HR 1.57, 95% CI 1.2–2.0) and T score (relative to T0, T1: HR 1.96, 95% CI 1.1–3.7, T2: HR 3.03, 95% CI 1.6–5.9) as strong predictors of poor renal outcomes. Subgroup analysis showed that patients with low C3/C4 ratios benefited from glucocorticoids or other immunosuppressive agents (hazard ratio 0.30 and 0.18, 95% CI 0.13–0.72 and 0.07–0.46, respectively). Serum C3/C4 ratios may be an independent novel predictor of renal outcomes in IgAN patients. Decreased C3/C4 ratios suggest poor renal outcomes and the potential to benefit from aggressive immunosuppressive therapies.

Journal

Immunologic ResearchSpringer Journals

Published: May 30, 2018

References

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