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Abstract: FR-PO1053

C3 Glomerulopathy: Pattern of Injury and Response to Treatment

Session Information

Category: Glomerular Diseases

  • 1202 Glomerular Diseases: Immunology and Inflammation

Author

  • Castillo, Luis A., Clínica de la Costa, Barranquilla, Atlántico, Colombia
Background

C3 glomerulopathy refers to those renal lesions characterized histologically by predominant C3 accumulation within the glomerulus with absent or scanty immunoglobulin deposition, and pathogenetically by aberrant regulation of the alternative pathway of complement. Objectives:To describe the evolution of renal involvement and the response to treatment with 1year follow- up.

Methods

Observational study case series type. The data were extracted from NefroRed©, a platform that contains the socio-demographic, anthropometric, clinical and laboratory data of 1340 patients with kidney biopsies from 2007-2015 . It was selected for the study those patients that showed the pattern of glomerulonephathy and C3 deposits only or predominant. The primary endpoint for subjects enrolled was change in proteinuria and serum creatinine over treatment period. Patients will be subclassified into three groups, those who had been treated with mycophenolate mofetil (MMF), Cyclophosphamide (CP) and those who had anti-complement therapy with eculizumab (ECZ). Statistical analysis descriptive.

Results

34 patients with C3 glomerulopathy were identified. Pathological lesion: 80% membranoproliferative glomerulonphritis , 6.7% GSFS , 6.7% mesangial proliferative ,6.7% membranous. Clinical preentation: 86.67% Nephrotic Syndrome , 26.67% nephrytic syndrome, 13% renal insuficiency, 53.33% Hypertension. 15 patients received active treatment with CP, 12 with MMF and 3 with eculizumab.

Conclusion

The scope of the study is limited largely because of the rarity of these disorders. There was not a response to ECZ. The treatment with MMF improved proteinuria but not renal function. The CP improved proteinuria and creatinine .Reports suggest that a in our population the cyclophosphamide is more effective. Formal trial of comprising a greater number of well-characterized patients is warranted.

Comparison of the CrSr and Proteinuria between MMF, ECZ and CP
SrCrBaseline12 monthsp-value
MMF1.52 CI 0.741.21 CI 0.38NS
ECZ3.01 CI 2.071.83 CI 0.47NS
CP1.53 CI 0.951.10 CI 0.42〈0.05
ProtBaseline12 monthsp-value
MMF1677.42 CI 1031.831212.42 CI 717.24〈0.05
ECZ1266.33 CI 1735.971162.67 CI 1382.19NS
CP2624.00 CI 1882.232098.44 CI 1608.42〈0.05

MMF: Mofetil Mycophenolate; CP: Cyclophosphamide; ECZ: Eculizumab; SrCr: Serum Creatinine; NS: Not Significant.