Abstract: PO1943
Low Serum C3 at Diagnosis of Pauci-Immune Glomerulonephritis Is Associated with More Advanced Kidney Impairment and Worst Renal Prognosis
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Trials - 3
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Lionaki, Sophia, Nephrology, Laiko Hospital, Athens, Greece
- Marinaki, Smaragdi, Nephrology, Laiko Hospital, Athens, Greece
- Kalaitzakis, Emmanuel, Nephrology, Laiko Hospital, Athens, Greece
- Fragkioudaki, Sofia, Nephrology, Laiko Hospital, Athens, Greece
- Kalogeropoulos, Petros, Nephrology, Laiko Hospital, Athens, Greece
- Liapis, Georgios, Pathology, Laiko Hospital, Athens, Greece
- Tzioufas, Athanasios, Pathophysiology, Laiko Hospital, Athens, Greece
- Boletis, Ioannis, Nephrology, Laiko Hospital, Athens, Greece
Background
Recent evidence supports the notion that complement activation plays a critical role in pauci-immune (PI) vasculitis pathogenesis. The aim of this study was to investigate if the clinical, serological and laboratory characteristics and treatment outcomes of patients with PI glomerulonephritis (GN) with low serum complement levels at diagnosis differ from those of patients with complement values within the normal range.
Methods
In a retrospective design we studied patients with biopsy proven PIGN with available serum complement measurements at diagnosis, or during a relapse, prior to initiation of immunosuppressive therapy. All patients were tested for antineutrophil cytoplasmic antibodies (ANCA) at presentation. Fisher's exact tests and Wilcoxon rank sum tests were used to compare the characteristics by serum C3.
Results
Of 96 patients included in the study, 22 (22.9%) had low serum C3 at diagnosis. Comparison of clinical, serological and laboratory characteristics and outcomes between the two groups is shown in [table 1].
Conclusion
Almost one quarter of patients with biopsy proven PIGN had low serum C3 at diagnosis in this cohort. These patients had more advanced renal impairment, required acute dialysis more frequently and were more likely to end up in end-stage kidney disease compared to patients with serum C3 within the normal range.
Characteristic Mean(sd) or Ν(%) | PIGN with low serum C3 Ν=22 | PIGN with normal serum C3 Ν=74 | p value |
Age (years) | 60.4(±13.1) | 58.3 (±15.6) | 0.42 |
Gender (male) | 12 (57.1) | 35 (47.3) | 0.45 |
BVAS | 16.6 (±5.35) | 17.7 (±5.75) | 0.89 |
ANCA type | |||
P/MPO-ANCA | 14(63.6) | 44(59.45) | 0.71 |
C/PR3-ANCA | 6 (27.3) | 25 (33.8) | |
Negative | 2 (9.1) | 5 (6.75) | |
Clinical phenotype | |||
Microscopic Polyangiitis | 11(50) | 29 (39.2) | |
Polyangiitis with Granulomatosis | 5 (22.7) | 17 (22.9) | 0.38 |
Kidney limited disease | 6 (27.3) | 28 (37.8) | |
Serum creatinine (mg/dl) | 8.25 (±3.8) | 2.875 (±1.9) | <0.0001 |
Peak serum creatinine (mg/dl) | 10.8 (±3.3) | 2.9 (±1.7) | <0.0001 |
Patients requiring acute dialysis | 10 (±47.6) | 13 (±17.5) | 0.004 |
Outcome | |||
Remission | 13(59.1) | 55(74.2) | 0.17 |
ESKD | 9(40.9) | 10 (13.6) | 0.006 |