Comparison of dominant and nondominant C3 deposition in primary glomerulonephritis
- Author:
Jiwon RYU
1
;
Eunji BAEK
;
Hyung-Eun SON
;
Ji-Young RYU
;
Jong Cheol JEONG
;
Sejoong KIM
;
Ki Young NA
;
Dong-Wan CHAE
;
Seong Pyo KIM
;
Su Hwan KIM
;
Jong Hyun JHEE
;
Tae Ik CHANG
;
Bum Soon CHOI
;
Ho Jun CHIN
;
Author Information
- Publication Type:Original Article
- From:Kidney Research and Clinical Practice 2023;42(1):98-108
- CountryRepublic of Korea
- Language:English
- Abstract: Alternative complement pathway dysregulation plays a key role in glomerulonephritis (GN) and is associated with C3 deposition. Herein, we examined pathological and clinical differences between cases of primary GN with C3-dominant (C3D-GN) and nondominant (C3ND-GN) deposition. Methods: We extracted primary GN data from the Korean GlomeruloNEphritis sTudy (KoGNET). C3D-GN was defined as C3 staining two grades greater than C1q, C4, and immunoglobulin via immunofluorescence analysis. To overcome a large difference in the number of patients between the C3D-GN and C3ND-GN groups (31 vs. 9,689), permutation testing was used for analysis. Results: The C3D-GN group exhibited higher serum creatinine (p ≤ 0.001), a greater prevalence of estimated glomerular filtration rate of <60 mL/min/1.72 m2 (p ≤ 0.001), higher (but not significantly so) C-reactive protein level, and lower serum C3 level (p ≤ 0.001). Serum albumin, urine protein/creatinine ratio, number of patients who progressed to end-stage renal disease, and all-cause mortality were comparable between groups. Interstitial fibrosis and mesangial cellularity were greater in the C3D-GN group (p = 0.04 and p = 0.01, respectively) than in the C3ND-GN group. C3 deposition was dominant in the former group (p < 0.001), in parallel with increased subendothelial deposition (p ≤ 0.001). Conclusion: Greater progression of renal injury and higher mortality occurred in patients with C3D-GN than with C3ND-GN, along with pathologic differences in interstitial and mesangial changes.
