MO231: Comparison of Dominant and Non-Dominant C3 Deposition in Primary Glomerulonephritis

Abstract

Abstract BACKGROUND AND AIMS Alternative complement pathway (AP) dysregulation plays a key role in glomerulonephritis (GN) and is associated with C3 deposition. Herein, we examined pathological and clinical differences between cases of primary GN with C3-dominant (C3D-GN) and non-dominant (C3ND-GN) deposition. METHOD We extracted primary GN data from the Korean GlomeruloNEphritis sTudy (KoGNET). C3D-GN was defined as C3 staining two grades greater than C1q, C4 and immunoglobulin via immunofluorescence analysis. Data between groups were age- and sex-matched (each group, n = 61). RESULTS The C3D-GN group exhibited higher serum creatinine (P = .027), greater prevalence of estimated glomerular filtration rates < 60 mL/min/1.72 m2 (P = .009), higher C-reactive protein levels (P = .003) and lower serum C3 levels (P = .018). Serum albumin, urine protein/creatinine ratio, number of patients who progressed to end-stage renal disease and mortality were comparable between groups. Interstitial fibrosis and tubular atrophy were greater in the C3D-GN group (P = .0027 and .005, respectively) than in the non-C3GN group. C3 deposition was dominant in the former group (P < .001), in parallel with increased subendothelial deposition (P = .003). CONCLUSION Greater progression of renal injury and inflammation occurred in patients with C3D-GN than with C3ND-GN, potentially owing to AP dysregulation.