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Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study

BACKGROUND: The complement system has been recently proposed to play an important role in the pathogenesis of ANCA-associated vasculitis (AAV). This study evaluated the value of serum and kidney deposited C3 in predicting renal outcomes in AAV. METHODS: This was a retrospective study of 47 patients...

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Autores principales: Chalkia, Aglaia, Thomas, Konstantinos, Giannou, Panagiota, Panagiotopoulos, Alexandros, Hadziyannis, Emilia, Kapota, Athanasia, Gakiopoulou, Harikleia, Vassilopoulos, Dimitrios, Petras, Dimitrios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7472496/
https://www.ncbi.nlm.nih.gov/pubmed/32787590
http://dx.doi.org/10.1080/0886022X.2020.1803086
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author Chalkia, Aglaia
Thomas, Konstantinos
Giannou, Panagiota
Panagiotopoulos, Alexandros
Hadziyannis, Emilia
Kapota, Athanasia
Gakiopoulou, Harikleia
Vassilopoulos, Dimitrios
Petras, Dimitrios
author_facet Chalkia, Aglaia
Thomas, Konstantinos
Giannou, Panagiota
Panagiotopoulos, Alexandros
Hadziyannis, Emilia
Kapota, Athanasia
Gakiopoulou, Harikleia
Vassilopoulos, Dimitrios
Petras, Dimitrios
author_sort Chalkia, Aglaia
collection PubMed
description BACKGROUND: The complement system has been recently proposed to play an important role in the pathogenesis of ANCA-associated vasculitis (AAV). This study evaluated the value of serum and kidney deposited C3 in predicting renal outcomes in AAV. METHODS: This was a retrospective study of 47 patients with AAV, who were categorized according to their serum C3 levels as hypo- or normo-complementemic and to those with positive or negative kidney biopsy immunofluorescence (IF) for C3. Baseline characteristics as well as progression to end-stage renal disease (ESRD) between the 2 groups were compared. RESULTS: In total, 23% (11/47) were hypo-complementemic; these patients were older (74 vs. 65 years, p = 0.013), had higher creatinine levels (4.9 vs. 2.2 mg/dL, p = 0.006), were more often hemodialysis dependent (64% vs. 19%, p = 0.009) and progressed more often to ESRD (55% vs. 11%, p = 0.01) compared to normo-complementemic patients (n = 36). On multivariate analysis, serum creatinine at diagnosis (HR = 16.8, 95%CI: 1.354–208.62, p = 0.028) and low serum C3 (HR = 2.492; 95% CI: 1.537–11.567; p = 0.044) were independent predictors for ESRD. Among 25 patients with an available kidney biopsy, 56% had C3 deposition by IF and displayed more often a mixed histological pattern (72% vs. 27%, p = 0.033), low serum C3 levels (42% vs. 18%, p < 0.001) and serious infections during follow-up (57% vs. 18%, p = 0.047) compared to those with negative (n = 11) IF staining. CONCLUSION: Almost one of four patients with AAV has low C3 levels at diagnosis which is associated with more severe renal disease and worse renal outcomes (ESRD). This should be taken into account in therapeutic and monitoring strategies.
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spelling pubmed-74724962020-09-15 Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study Chalkia, Aglaia Thomas, Konstantinos Giannou, Panagiota Panagiotopoulos, Alexandros Hadziyannis, Emilia Kapota, Athanasia Gakiopoulou, Harikleia Vassilopoulos, Dimitrios Petras, Dimitrios Ren Fail Clinical Study BACKGROUND: The complement system has been recently proposed to play an important role in the pathogenesis of ANCA-associated vasculitis (AAV). This study evaluated the value of serum and kidney deposited C3 in predicting renal outcomes in AAV. METHODS: This was a retrospective study of 47 patients with AAV, who were categorized according to their serum C3 levels as hypo- or normo-complementemic and to those with positive or negative kidney biopsy immunofluorescence (IF) for C3. Baseline characteristics as well as progression to end-stage renal disease (ESRD) between the 2 groups were compared. RESULTS: In total, 23% (11/47) were hypo-complementemic; these patients were older (74 vs. 65 years, p = 0.013), had higher creatinine levels (4.9 vs. 2.2 mg/dL, p = 0.006), were more often hemodialysis dependent (64% vs. 19%, p = 0.009) and progressed more often to ESRD (55% vs. 11%, p = 0.01) compared to normo-complementemic patients (n = 36). On multivariate analysis, serum creatinine at diagnosis (HR = 16.8, 95%CI: 1.354–208.62, p = 0.028) and low serum C3 (HR = 2.492; 95% CI: 1.537–11.567; p = 0.044) were independent predictors for ESRD. Among 25 patients with an available kidney biopsy, 56% had C3 deposition by IF and displayed more often a mixed histological pattern (72% vs. 27%, p = 0.033), low serum C3 levels (42% vs. 18%, p < 0.001) and serious infections during follow-up (57% vs. 18%, p = 0.047) compared to those with negative (n = 11) IF staining. CONCLUSION: Almost one of four patients with AAV has low C3 levels at diagnosis which is associated with more severe renal disease and worse renal outcomes (ESRD). This should be taken into account in therapeutic and monitoring strategies. Taylor & Francis 2020-08-13 /pmc/articles/PMC7472496/ /pubmed/32787590 http://dx.doi.org/10.1080/0886022X.2020.1803086 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Chalkia, Aglaia
Thomas, Konstantinos
Giannou, Panagiota
Panagiotopoulos, Alexandros
Hadziyannis, Emilia
Kapota, Athanasia
Gakiopoulou, Harikleia
Vassilopoulos, Dimitrios
Petras, Dimitrios
Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study
title Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study
title_full Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study
title_fullStr Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study
title_full_unstemmed Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study
title_short Hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with ANCA-associated vasculitis: a retrospective cohort study
title_sort hypocomplementemia is associated with more severe renal disease and worse renal outcomes in patients with anca-associated vasculitis: a retrospective cohort study
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7472496/
https://www.ncbi.nlm.nih.gov/pubmed/32787590
http://dx.doi.org/10.1080/0886022X.2020.1803086
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