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Abstract: TH-PO773

Prognosis of C1q Nephropathy Is Not Different According to the Presence of Segmental Sclerosis or Nephrotic Proteinuria

Session Information

Category: Glomerular Diseases

  • 1201 Glomerular Diseases: Fibrosis and Extracellular Matrix

Authors

  • Ryu, Ji Young, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
  • Son, Hyung Eun, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
  • Chin, Ho Jun, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
Background

C1q nephropathy is pathologically defined, however, clinical characteristics and prognosis of it remain poorly understood.

Methods

We collected the clinical and pathologic findings of 6413 adult patients with renal biopsy since 2000. We selected 29 patients followed more than 3 months after renal biopsy among 34 patients diagnosed as C1q nephropathy. We matched age and gender to the patients with FSGS and MCD and analyzed the incidence of ESRD.

Results

In patients with C1q nephropathy, estimated GFR was 83.2± 34.7 (20.1-126.9) ml/min/1.73 m2 and UPCR was 3.30 ± 4.08 (0.05-18.53) g/g creatinine. Glomerular segmental sclerosis (SS) was present in 14 (48.3 %) patients. Patients with SS had higher level of systolic blood pressure and lower level of eGFR compared to patients without SS (127.0 ± 9.8 vs 114.5 ± 13.0 mmHg, p=0.010, and 67.4± 31.8 vs 98.0 ± 31.3 ml/min/1.73 m2 , p=0.016, respectively). Other findings such as UPCR and pathologic findings except amount of SS were not different between groups. The levels of eGFR and UPCR at 6 months after renal biopsy was not different in C1q patients according to the presence of SS. There were 17.2 % (5/29) incidence of ESRD during 94.2 ± 48.6 months. The most important prognostic factors were the amount of glomerular global sclerosis by Cox’s hazard proportional model adjusted by age, gender, eGFR, and pathologic findings. The presence of SS or the level of UPCR at renal biopsy were not the independent risk factors to renal outcome. The renal outcome was worse in C1q nephropathy compared to MCD (0/28), but, similar between C1q nephropathy and FSGS (6/28) (p=0.008 by Log-rank test).

Conclusion

Glomerular global sclerosis is the most important risk factor to the renal outcome rather than glomerular segmental sclerosis or UPCR in C1q nephropathy. The prognosis of C1q nephropathy was similar to that of FSGS and worse than that of MCD.