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Abstract: FR-PO860

The Significance of Glomerular C1q Deposits in Primary Membranous Nephropathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Author

  • Torikoshi, Kazuo, Nishi-Kobe Medical Center, Kobe, Japan
Background

Unlike a previous report of no C1q deposition in idiopathic membranous nephropathy (iMN), recent studies have shown trace C1q deposition even in iMN due to improvements in the sensitivity of detection methods. The aim of study was to examine the clinical and pathological significance of glomerular C1q deposits in iMN.

Methods

1) This single center retrospective study included 54 patients with MN who underwent renal biopsy from January 2005 to December 2017 (mean follow-up of 3.6±2.4 years). We evaluated remission of proteinuria (<1g/gCr) and other clinical examinations. 2) Next, after excluding patients with secondary MN (including hepatitis C virus infection, systemic lupus erythematosus, MCTD, malignancy and medication) (n=16), and those without immunofluorescence study (n=3), we selected 35 patients for further study. A variety of clinical parameters, outcomes and other serum and urine factors was compared in patients with and without significant glomerular capillary C1q deposits.

Results

1) In 54 patients, 16 patients (29.6%) were diagnosed with secondary MN due to the detection of secondary causes including drugs, malignant tumors, autoimmune diseases and infectious diseases. A total of 40 patients (74.1%) achieved remission of proteinuria: 26 (48.2%) complete and 14 (25.9%) partial remission. 2) Glomerular C1q deposition was detected on capillary walls by immunofluorescence in 21/35 (60.0%) patients with iMN. In the group with glomerular C1q deposits, the remission of urinary protein was significantly delayed using a log rank test (log rank=0.019). In iMN, glomerular C1q deposition was an unfavorable predictor for remission of proteinuria (hazard ratio (HR) 2.41, 95%CI=1.13-5.14, P=0.022) in Cox proportional hazards analysis.

Conclusion

These results suggest that glomerular capillary C1q deposition was associated with poor renal outcome.