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Abstract: PO1552

Characteristics and Outcomes of Immune-Complex Membranoproliferative Glomerulonephritis and C3 Glomerulonephritis in Japan: A Retrospective Analysis of Data from the Japan Renal Biopsy Registry

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Nakagawa, Naoki, Asahikawa Ika Daigaku, Asahikawa, Hokkaido, Japan
  • Kato, Sawako, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi, Japan
  • Maruyama, Shoichi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi, Japan
  • Narita, Ichiei, Niigata Daigaku Igakubu Igakuka Daigakuin Ishigaku Sogo Kenkyuka, Niigata, Niigata, Japan
  • Isaka, Yoshitaka, Osaka Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Suita, Osaka, Japan

Group or Team Name

  • Committee for Renal Biopsy and Disease Registry of the Japanese Society of Nephrology
Background

The reclassification of membranoproliferative glomerulonephritis (MPGN) into immune-complex mediated MPGN (IC-MPGN) and C3 glomerulopathy (C3G) based on immunofluorescence findings in kidney biopsies has provided insights into two distinct diseases. C3G is further classified into dense deposit disease and C3 glomerulonephritis (C3GN) based on electron micrographic findings. Although these diseases have poor outcomes, limited Japanese literature confined to small, single-center cohorts exist on these diseases.

Methods

We retrospectively analyzed 81 patients with MPGN type I and III from 15 hospitals in the Japan Renal Biopsy Registry (J-RBR) to compare demographic, clinical characteristics and treatment outcomes of patients with IC-MPGN to those with C3GN.

Results

Of the 81 patients reviewed by immunofluorescence findings in kidney biopsies, 67 patients had IC-MPGN and 14 patients had C3GN. Age at diagnosis, systolic and diastolic pressures, proteinuria, impaired renal function, and hypoalbuminemia were significantly higher in patients with IC-MPGN than in those with C3GN. About 80% of the patients in both groups were treated with immunosuppressive therapy. At last follow-up (median 4.8 years), complete remission rate of proteinuria was significantly higher in patients with C3GN (64.3%) than in those with IC-MPGN (29.9%; P = 0.015). The renal survival rate was lower in patients with IC-MPGN when compared to C3GN (73.1% vs. 100%; log-rank, P = 0.031). Systolic blood pressure and renal function at baseline were independent predictors of progression to end-stage kidney disease.

Conclusion

The overall prognosis of patients with C3GN is more favorable than for patients with IC-MPGN.

Funding

  • Government Support – Non-U.S.