Kidney Week

Abstract: PO1853

C3 Glomerulonephritis Associated with Monoclonal Gammopathy: A Retrospective Case Series Study from a Single Institute in China

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Trials - 1
  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

• Zhang, Xin, Peking University First Hospital, Beijing, Beijing, China

Xin Zhang,

• Xiaojuan, Yu, Peking University First Hospital, Beijing, Beijing, China

Yu Xiaojuan,

• Li, Dan Yang, Peking University First Hospital, Beijing, Beijing, China

Dan Yang Li,

• Wang, Su-xia, Peking University First Hospital, Beijing, Beijing, China

Su-xia Wang,

• Zhou, Fu De, Peking University First Hospital, Beijing, Beijing, China

Fu De Zhou,

• Zhao, Ming Hui, Peking University First Hospital, Beijing, Beijing, China

Ming Hui Zhao,

Background

To analysis the demographic and clinicopathological features and renal outcomes of Chinese patients with C3GN in the setting of monoclonal gammopathy.

Methods

Patients with renal biopsy-proven C3 glomerulonephritis and detectable serum and/or urine monoclonal Ig from 2006 to 2018 in Peking University First Hospital were included, clinical data, renal pathology type, treatment and prognosis were collected.

Results

Nineteen patients were enrolled, accounting for contemporaneous 26.7% of C3GN patients. The mean age was 55 years old, and average eGFR at biopsy 48.42ml/min/1.73m². The IgG was the most common isotype of monoclonal Ig on immunofixation electrophoresis. Eleven patients had nephrotic ranged proteinuria and hypoalbuminemia. Kidney biopsies revealed a relative prominent MPGN pattern. Two patients had concurrent TMA-like renal injuries. The median renal survival was 24 months. Median renal survival was 12, 12, and 34 months, respectively in patients receiving conservative therapy, immunosuppressant therapy, and clone-targeted chemotherapy, without statistical significance. Plasma exchange therapy only improved one patient’s renal outcome.

Conclusion

The clinicopathological features of Chinese patients with C3GN combined with monoclonal gammopathy are consistent with the previously reported population. Renal prognosis of these patients is poor, and immunosuppressant therapies show no advantage over supportive therapy in renal prognosis, while the benefit of clone-targeted chemotherapy is still requiring investigation.

Funding

• Government Support - Non-U.S.