Serum IgA/C3 and glomerular C3 staining predict severity of IgA nephropathy

摘要

Abstract Background The aim of this study was to determine whether serum immunoglobulin A/complement factor 3 (IgA/C3) ratio and glomerular C3 staining predict outcome in IgA nephropathy. Methods We collected data for 44 IgA nephropathy children treated with multi‐drug combination therapy. The children were retrospectively divided into four groups based on serum IgA/C3 ratio and glomerular C3 staining: group A, IgA/C3 ratio 2.68 (median) and glomerular C3 staining ≥2.0, n?=?9; group B, IgA/C3 ratio 2.68 and glomerular C3 staining 2.0, n?=?7; group C, IgA/C3 ratio 2.68 and glomerular C3 staining ≥2.0, n?=?7; and group D, IgA/C3 ratio 2.68 and glomerular C3 staining 2.0, n?=?21. Clinical features; pathology at the first and second renal biopsy and at the latest follow up; and prognosis were analyzed for the four groups. Results At the most recent follow up, urinary protein excretion, incidence of hematuria, and serum creatinine in group A were all higher than in group D. At the second biopsy, crescent absence/presence ratio; mesangial hypercellularity, segmental glomerulosclerosis or adhesion, endocapillary hypercellularity, and tubular atrophy/interstitial fibrosis as well as crescents and global glomerulosclerosis ( MESTCG ) score; and clonicity index in group A were higher than in group D. All patients in group D had normal urine, and the prevalence of persistent nephropathy in group A was higher than in group D. Conclusions Serum IgA/C3 ratio and glomerular C3 staining can predict outcome in IgA nephropathy.