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Abstract: SA-PO917

Change in GFR and UPC (Urinary Protein:Creatinine Ratio) Before and After Eculizumab in C3 Glomerulopathy

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Liu, Tina, University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Fergus, Lauren O., University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Hall, Monica D., University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Walker, Patrick D., Arkana Laboratories, Little Rock, Arkansas, United States
  • Smith, Richard J., University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Nester, Carla Marie, University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
Background

C3 Glomerulopathy (C3G) is an ultra-rare kidney disease characterized by alternative complement pathway dysregulation. Most patients reach end-stage renal disease (ESRD) within 10 years of diagnosis. The complement inhibitor, eculizumab, has been used to treat C3G with mixed results. In this study, we compared differences in GFR and UPC trends in a cohort of C3G patients before and after eculizumab treatment.

Methods

14 patients from the University of Iowa’s C3G Natural History Study were included in the cohort. Inclusion criteria: baseline native biopsy diagnosis of C3G and ≥1 year of clinical data (C3, GFR, UPC) prior to and after starting eculizumab. Exclusion criteria: teatment with other complement inhibitors, dialysis, and kidney transplant. Simple linear regression of the change in GFR and UPC before and after eculizumab initiation was measured. Paired t-test with p values were used to evaluate the significance of GFR and UPC change pre/post treatment; p < 0.05.

Results

GFR changes per year pre/post eculizumab were insignificant (p = 0.201). Trends showed a pattern of GFR decline with a median difference from pre- to post-eculizumab of -6.47. UPC change per year was also not significant (p = 0.981). General patterns showed improvement with a median difference in UPC change per year pre/post eculizumab of -0.26.

Conclusion

Most patients showed no significant change in disease trajectory with eculizumab therapy. There was a general trend towards worsening kidney function following eculizumab, though with a slight decrease in UPC. Limitations include sample size and gross slope estimation with only simple linear regression. Future directions include examining the baseline C3G histology, complement biomarkers, and other clinical markers to determine if outcome may be predicted.

Funding

  • NIDDK Support