Serum complement C4 is an important prognostic factor for IgA nephropathy: a retrospective study

Tong-Dan Bi,Long-Shu Yang,Lin-Lin Liu,Jun-Xiao Zhang,Jian-Nan Zheng,Nan Liu,Li Yao

doi:10.1186/s12882-019-1420-0

Tong-Dan Bi, Long-Shu Yang + Show 5 more

Open Access

https://doi.org/10.1186/s12882-019-1420-0

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Abstract

BackgroundIgA nephropathy (IgAN) is the most common glomerulonephritis worldwide and is an important cause of end-stage renal disease (ESRD). Exploring novel biomarkers is necessary for predicting the disease activity and progression of IgAN patients. The present study sought to investigate the value of serum C4 for predicting the prognosis of IgAN patients.MethodsThe primary endpoint of this retrospective study was a composite event of either a ≥ 50% reduction in estimated glomerular filtration rate (eGFR) or end-stage renal disease (ESRD) or death. The associations between serum C4 and clinicopathological parameters and prognosis of this cohort of IgAN patients were evaluated.ResultsThe present study included 1356 IgAN patients. Serum C4 levels correlated significantly with clinical prognostic factors. Serum C4 levels correlated positively with urinary protein excretion (r = 0.307, P < 0.001), and negatively correlated with estimated glomerular filtration rate (r = − 0.281, P < 0.001). Furthermore, serum C4 levels increased with aggravation of tubulointerstitial injury, crescents and ratios of global sclerosis (all P < 0.05). Prognostic analyses with the Cox proportional hazards regression model and Kaplan-Meier survival curves further identified serum C4 as an independent risk factor for the prognosis of IgAN.ConclusionsThe present study identified serum C4 as a useful predictor for the prognosis of IgAN patients. The mechanism of the trend of serum C4 in IgAN needs to be illustrated in further research.

Highlights

IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide and is an important cause of end-stage renal disease (ESRD)
IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide; IgAN is an important cause of end-stage renal disease (ESRD) and is not a benign condition [1,2,3]
The present study demonstrated that high serum C4 levels were correlated with severe clinical and pathological manifestations, and serum C4 was further identified as an independent risk factor for the progression of IgAN

Summary

Introduction

IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide and is an important cause of end-stage renal disease (ESRD). The present study sought to investigate the value of serum C4 for predicting the prognosis of IgAN patients. IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide; IgAN is an important cause of end-stage renal disease (ESRD) and is not a benign condition [1,2,3]. The hallmark of IgAN is the predominant deposition of galactose-deficient IgA1-containing immune complexes in the glomerular mesangium, and complement C3 is always present. These characteristics suggest that IgAN is an immune-mediated kidney disease, and complement. To identify the value of serum complement C4 for predicting the prognosis of IgAN patients, we performed the present study with 1356 IgAN patients and retrospectively analyzed the associations of serum complement C4 with clinicopathological parameters and prognosis of IgAN patients

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