Positive C1q staining associated with poor renal outcome in membranoproliferative glomerulonephritis.

Background: Pathogenesis and clinical prognosis of membranoproliferative glomerulonephritis (MPGN) has not yet been established. Methods: We conducted a retrospective study of 41 patients with MPGN (type I and III) and examined the renal survival. In addition, factors contributing to survival time were analyzed. Results: Fourteen patients (34 %) were classified into the renal death group. Patients with nephrotic syndrome and positive C1q staining of glomerular deposits showed a particularly poor prognosis. Significantly higher frequency of nephrotic syndrome and higher urinary protein excretion were observed in the renal death group ( p = 0.0002, p = 0.0002) than in the renal survival group. The intensity of C1q staining was positively correlated with the severity of the proteinuria ( p = 0.004). Factors that influenced the survival time were positive C1q staining of glomerular deposits ( p = 0.003), presence of nephrotic syndrome ( p = 0.004), serum albumin ( p = 0.02), and proteinuria ( p = 0.04). Conclusions: C1q staining in glomerular deposits and nephrotic syndrome were important factors influencing the prognosis and outcome in MPGN patients. C1q deposition may play a key role in the pathogenesis of MPGN, as evidenced by numerous observations, such as induction of proteinuria. [ABSTRACT FROM AUTHOR]