Serum C4/C3 ratio in predicting the adverse prognosis of IgA nephropathy

Abstract

Abstract:

AIM: To investigate the relationship between serum complement levels and prognosis of IgA nephropathy. METHODS: Patients diagnosed through renal biopsy as primary IgA nephropathy from 2009 to 2013 in our hospital were recruited into this retrospective study. Baseline demographic, clinical laboratory examination, renal biopsy and histopathology examination, as well as the follow-up results were reviewed. The ratio of serum complement C4 to C3 (C4/C3 ratio, marked as C. ratio) was calculated. Multiple statistical methods were used to investigate the relationship between C. ratio and nephropathy prognosis. All statistics were calculated using R software and related software packages. RESULTS:A total of 206 patients were enrolled in the present study, and the median follow-up time was (37.2±6.5) months. There were 88 (42.8%) male patients. The comparison of different pathological changes of nephropathy with C.ratio showed that the C.ratio levels were significantly higher in mesangial hypercellularity, segmental fibrosis/adhesion, and interstitial fibrosis/tubular atrophy. ROC curve showed that C.ratio could effectively identify the adverse prognosis of IgA nephropathy, the area under the ROC curves was 0.735 for C.ratio, with a cut-off value of 0.25 (sensitivity: 70.9%, specificity: 72.2%). In addition, higher C.ratio (>0.25) was associated with higher diastolic blood pressure, and greater proteinuria. Kaplan-meier survival analysis also confirmed that patients with higher level of C.ratio had significantly poorer nephropathy prognosis after adjusted by age, gender, blood pressure and urine protein, the Hazard Ratio was 5.1(95%CI, 1.9-13.9, P=0.001). CONCLUSION: High level of serum C4 to C3 ratio was significantly associated with poor prognosis of IgA nephropathy; this could be used as a clinical prognosis predictor in IgA nephropathy patients.

Key words: IgA nephropathy, complement C3, complement C4

CLC Number:

R965.2

ZHOU Qiongxiu, ZHANG Jianna, YOU Xiaohan, LV Yinqiu, CHEN Bo, ZHANG Ji . Serum C4/C3 ratio in predicting the adverse prognosis of IgA nephropathy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(8): 881-886.

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