Abstract: SA-PO651
C3 Dominant Deposition in ANCA-Associated Glomerulonephritis
Session Information
- Glomerular Diseases: ANCA, Anti-GBM, Kidney Biopsy
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Oba, Rina, The Jikei University School of Medicine, Minato-ku, ToKyo, Japan
- Kanzaki, Go, The Jikei University School of Medicine, Minato-ku, ToKyo, Japan
- Sasaki, Takaya, The Jikei University School of Medicine, Minato-ku, ToKyo, Japan
- Okabayashi, Yusuke, The Jikei University School of Medicine, Minato-ku, ToKyo, Japan
- Haruhara, Kotaro, The Jikei University School of Medcine, South Yarra, Victoria, Australia
- Koike, Kentaro, The Jikei University School of Medicine, Minato-ku, ToKyo, Japan
- Hirano, Keita, Ashikaga Red Cross Hospital, Ashikagas-shi, Tochigi prefecture, Japan
- Tsuboi, Nobuo, The Jikei University School of Medicine, Minato-ku, ToKyo, Japan
- Yokoo, Takashi, The Jikei University School of Medicine, Minato-ku, ToKyo, Japan
Background
It has been reported that Anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (ANCA-GN) is characterized by necrotizing crescentic glomerulonephritis with few immune and complement deposits. Several recent studies have implied that complement activation plays an important role in the pathogenesis of ANCA-GN. However, the clinical and pathological significance of C3 deposits in patients with ANCA-GN has not been fully elucidated. This current study investigated the characteristics of C3 dominant deposition in ANCA-GN.
Methods
Kidneys specimens from 61 subjects with ANCA-GN were retrospectively evaluated at Jikei University School of Medicine Hospital, Atsugi City Hospital and Japanese Red Cross Ashikaga Hospital, Japan, during biopsy performed between 2004 and 2019. Clinical and histopathological data at kidney biopsy were compared between the patients with and without C3 deposits. The dominant deposition was defined as the presence of C3 for at least 1+ in a 0–3+ scale without other immune and complement deposits.
Results
Figure provides clinical and histopathological data for the ANCA-GN patients with and without C3 dominant deposits. Demographic data, estimated glomerular filtration rate (eGFR), and urine protein were similar between the two groups, indicating that renal function at biopsy was unlikely to associate with C3 deposition. Compared with patients without C3 dominant deposition, patients with C3 dominant deposition had a higher level of C3 (P=0.003) and a poorer renal outcome at one year after biopsy (P=0.025). Although there was no difference in the rate of glomerular cellular crescent formation or global sclerosis, the patients with C3 dominant deposition had a higher percentage of fibrocellular or fibrous crescent.
Conclusion
These results suggest that C3 deposition and complement activation would be associated with chronic histological changes and poor renal outcome in ANCA-GN.