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Predictive value of mesangial C3 and C4d deposition in IgA nephropathy

Authors
 Ki Heon Nam  ;  Young Su Joo  ;  Changhyun Lee  ;  Sangmi Lee  ;  Joohwan Kim  ;  Hae-Ryong Yun  ;  Jung Tak Park  ;  Tae Ik Chang  ;  Dong-Ryeol Ryu  ;  Tae-Hyun Yoo  ;  Ho Jun Chin  ;  Shin-Wook Kang  ;  Hyeon Joo Jeong  ;  Beom Jin Lim  ;  Seung Hyeok Han  ;  Korean GlomeruloNEphritis sTudy (KoGNET) Group 
Citation
 CLINICAL IMMUNOLOGY, Vol.211 : 108331, 2020-02 
Journal Title
 CLINICAL IMMUNOLOGY 
ISSN
 1521-6616 
Issue Date
2020-02
Keywords
C3 ; C4d ; Complement ; IgA nephropathy
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.
Full Text
https://www.sciencedirect.com/science/article/pii/S1521661619305777
DOI
10.1016/j.clim.2019.108331
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Nam, Ki Heon(남기헌) ORCID logo https://orcid.org/0000-0001-7312-7027
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Yun, Hae Ryong(윤해룡) ORCID logo https://orcid.org/0000-0002-7038-0251
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
Jeong, Hyeon Joo(정현주) ORCID logo https://orcid.org/0000-0002-9695-1227
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179017
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