Long-Term Renal Survival in Antineutrophil Cytoplasmic Antibody–Associated Glomerulonephritis With Complement C3 Deposition
Rina Oba, Go Kanzaki, Takaya Sasaki, Yusuke Okabayashi, Kotaro Haruhara, Masahiro Okabe, Shinya Yokote, Kentaro Koike, Keita Hirano, Hideo Okonogi, Nobuo Tsuboi, Takashi Yokoo
Abstract
INTRODUCTION: Recent studies have revealed the pivotal role of complement activation in the pathogenesis of antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN). This study investigated the clinicopathologic and prognostic significance of glomerular C3 deposition in the renal histopathology of patients with ANCA-GN. METHODS: We retrospectively identified 142 patients with ANCA-GN from 6 hospitals in Japan (2004-2020). C3 deposition was defined as C3 staining ≥1+ on a scale of 0 to 2+ using direct immunofluorescence (IF). The primary composite end points included a 30% reduction in estimated glomerular filtration rate (eGFR), end-stage kidney disease (ESKD), and death. We compared clinicopathologic features and long-term outcomes between patients with and without C3 deposition. RESULTS: = 0.008). CONCLUSION: This study revealed that ANCA-GN patients with glomerular C3 deposition on IF had worse renal and overall survival rates.