Back to Search
Start Over
Mesangial C4d deposition at diagnosis in childhood immunoglobulin A nephropathy.
- Source :
- Pediatrics International; Nov2019, Vol. 61 Issue 11, p1133-1139, 7p, 1 Color Photograph, 4 Charts, 1 Graph
- Publication Year :
- 2019
-
Abstract
- Background: Immunoglobulin A nephropathy (IgAN) is a major cause of end‐stage renal disease. Complement activation via the lectin pathway influences outcomes in IgAN. We examined the association of glomerular C4d deposition with clinicopathological severity at diagnosis and the disappearance of proteinuria in Japanese pediatric IgAN patients. Methods: We retrospectively analyzed 25 children newly diagnosed with IgAN at Hokkaido University Hospital. We evaluated glomerular C4d immunofluorescent staining at diagnosis. We compared clinical findings, pathological findings (based on Oxford classification), and the disappearance of proteinuria within 24 months after renal biopsy between C4d‐positive and C4d‐negative patients. Results: Glomerular C4d staining was observed in 14 patients (56.0%). C4d‐positive patients had significantly higher proteinuria at diagnosis than C4d‐negative patients (2.03 g/gCr vs 0.78 g/gCr; P = 0.005). The number of glomeruli with segmental glomerulosclerosis or adhesion (8.0% vs 0.0%; P = 0.046) and the extent of tubular atrophy/interstitial fibrosis (9.46% vs 2.86%; P = 0.031) were significantly increased in C4d‐positive patients compared with C4d‐negative patients. Further, the proportion of patients with modified T1 (>10%) was significantly higher in the C4d‐positive group than the C4d‐negative group. There was no significant difference, however, in the disappearance rate of proteinuria at 24 months after renal biopsy between groups (64% vs 82%; P = 0.149). Conclusions: Glomerular C4d deposition was associated with clinicopathological severity at diagnosis in Japanese pediatric patients with IgAN. Glomerular C4d deposition, however, was not a predictor of the disappearance of proteinuria within 24 months after diagnosis in Japanese pediatric patients with IgAN. [ABSTRACT FROM AUTHOR]
- Subjects :
- BIOPSY
COMPLEMENT (Immunology)
FLUORESCENT antibody technique
GLOMERULONEPHRITIS
KIDNEY glomerulus
PROTEINURIA
PULMONARY fibrosis
RISK assessment
STAINS & staining (Microscopy)
RETROSPECTIVE studies
SEVERITY of illness index
FOCAL segmental glomerulosclerosis
ATROPHY
DISEASE complications
DISEASE risk factors
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 13288067
- Volume :
- 61
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Pediatrics International
- Publication Type :
- Academic Journal
- Accession number :
- 139862346
- Full Text :
- https://doi.org/10.1111/ped.13921