Abstract: TH-PO012

The Relationship between Renal Arteriosclerotic Lesions in CKD and the Serum Levels of Complement C3 and Uric Acid

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Miyagi, Tsuyoshi, University of the Ryukyus, Okinawa, Japan
  • Fukuhara, Chisato, University of the Ryukyus, Okinawa, Japan
  • Zamami, Ryo, University of the Ryukyus, Okinawa, Japan
  • Kohagura, Kentaro, University of the Ryukyus, Okinawa, Japan
  • Ohya, Yusuke, University of the Ryukyus, Okinawa, Japan
  • Iseki, Kunitoshi, Tomishiro Central Hospital, Okinawa, Japan
Background

We previously reported that hyperuricemia (HUA) was related to renal arteriosclerosis in patients with chronic kidney disease (CKD). Serum complement C3 (C3), which is also an adipocytokine, has also been suggested to be related to renal arteriosclerosis. Here we examined the significance of concurrent occurrence of HUA and elevated C3 levels in renal arteriosclerosis.

Methods

This study involved 172 CKD patients whose biopsies were taken at our department. Of these patients, we excluded those who were receiving corticosteroids or calcineurin inhibitors, those with hypocomplementemia, and patients affected by disease which could cause morphological change in the renal arterioles. Arteriosclerosis was analyzed in renal pathological specimens obtained from renal biopsy using arteriolar hyalinization grade, which represents the mean grade obtained following semiquantitative assessment of the degree of hyalinization. Scores equal to or higher than the C3 median were classified into a high (HC3) group. The definition of HUA was determined as those taking antihyperuricemic drugs or those with serum uric acid levels ≥7 mg/dL for men and ≥6 mg/dL for women. The subjects were divided into four subgroups of HC3−/HUA−, HC3+/HUA−, HC3−/HUA+ and C3+/HUA+ by the presence or absence of HC3 and HUA and we then compared their arteriolar hyalinization grades.

Results

The mean arteriolar hyalinization grade after HC3/HUA subgrouping, and after logarithmic transformation, was highest for the HC3+/HUA+ subgroup, and a significant difference was observed with that for HC3−/HUA−. However, the differences between the HC3−/HUA− and HC3+/HUA− or HC3−/HUA+ subgroups were relatively small. We performed multivariate analysis of the determination factors of high arteriolar hyalinization (median grade or higher) including age, sex, pulse pressure, HbA1c, LDL-cholesterol level, and HC3/HUA subgroups (Ref: HC3−/HUA−). We found that HC3+/HUA+ (OR, 4.3; 95%CI, 1.2–15.9) was a significant factor. Furthermore, in comparison to the HC3−/HUA− subgroup, the flow-mediated dilation (%FMD) in the HC3+/HUA+ subgroup was significantly decreased.

Conclusion

In CKD patients, the relationship between HUA and renal arteriosclerosis may become more notable in patients with high levels of serum complement C3.