Predictive value of mesangial C3 and C4d deposition in IgA nephropathy

on behalf of The Korean GlomeruloNEphritis sTudy (KoGNET) Group

doi:10.1016/j.clim.2019.108331

Predictive value of mesangial C3 and C4d deposition in IgA nephropathy

on behalf of The Korean GlomeruloNEphritis sTudy (KoGNET) Group

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

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.

Original language	English
Article number	108331
Journal	Clinical Immunology
Volume	211
DOIs	https://doi.org/10.1016/j.clim.2019.108331
Publication status	Published - 2020 Feb

Bibliographical note

Funding Information:
This research was supported by a faculty research grant of Yonsei University College of Medicine for 2015, Seoul, Korea ( 4-2015-1084 ) and the Research Program funded by the Korea Centers for Disease Control and Prevention ( 2019ER690100 ).

Publisher Copyright:
© 2020 Elsevier Inc.

All Science Journal Classification (ASJC) codes

Immunology and Allergy
Immunology

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10.1016/j.clim.2019.108331

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title = "Predictive value of mesangial C3 and C4d deposition in 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.",

author = "{on behalf of The Korean GlomeruloNEphritis sTudy (KoGNET) Group} and Nam, {Ki Heon} and Joo, {Young Su} and Changhyun Lee and Sangmi Lee and Joohwan Kim and Yun, {Hae Ryong} and Park, {Jung Tak} and Chang, {Tae Ik} and Ryu, {Dong Ryeol} and Yoo, {Tae Hyun} and Chin, {Ho Jun} and Kang, {Shin Wook} and Jeong, {Hyeon Joo} and Lim, {Beom Jin} and Han, {Seung Hyeok}",

note = "Funding Information: This research was supported by a faculty research grant of Yonsei University College of Medicine for 2015, Seoul, Korea ( 4-2015-1084 ) and the Research Program funded by the Korea Centers for Disease Control and Prevention ( 2019ER690100 ). Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

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doi = "10.1016/j.clim.2019.108331",

language = "English",

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journal = "Clinical Immunology",

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T1 - Predictive value of mesangial C3 and C4d deposition in IgA nephropathy

AU - on behalf of The Korean GlomeruloNEphritis sTudy (KoGNET) Group

AU - Nam, Ki Heon

AU - Joo, Young Su

AU - Lee, Changhyun

AU - Lee, Sangmi

AU - Kim, Joohwan

AU - Yun, Hae Ryong

AU - Park, Jung Tak

AU - Chang, Tae Ik

AU - Ryu, Dong Ryeol

AU - Yoo, Tae Hyun

AU - Chin, Ho Jun

AU - Kang, Shin Wook

AU - Jeong, Hyeon Joo

AU - Lim, Beom Jin

AU - Han, Seung Hyeok

N1 - Funding Information: This research was supported by a faculty research grant of Yonsei University College of Medicine for 2015, Seoul, Korea ( 4-2015-1084 ) and the Research Program funded by the Korea Centers for Disease Control and Prevention ( 2019ER690100 ). Publisher Copyright: © 2020 Elsevier Inc.

PY - 2020/2

Y1 - 2020/2

N2 - 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.

AB - 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.

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Predictive value of mesangial C3 and C4d deposition in IgA nephropathy

Abstract

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