Association between glomerular C4d deposition, proteinuria, and disease severity in children with IgA nephropathy View Full Text


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Article Info

DATE

2022-09-14

AUTHORS

Weiran Zhou, Hui Wang, Shuzhen Sun, Ying Shen, Xuemei Liu, Junhui Zhen, Hongxia Zhang, Fan Duan, Yanyan Pan, Linlin Dong

ABSTRACT

BackgroundC4d may be used as a marker to evaluate the condition and prognosis of adults with IgA nephropathy, but there have been few studies of children with IgA nephropathy. MethodsC4d immunohistochemical staining was performed on samples from children with IgA nephropathy with C1q-negative immunofluorescence. The clinical and pathological treatment and prognostic characteristics of children in the C4d-positive and -negative groups were compared.ResultsA total of sixty-five children with IgA nephropathy were included in the study and were followed up for an average of 37 months. C4d was mainly deposited along the capillary loops. The urinary protein-to-creatinine ratio (UPCR) in the C4d-positive group was significantly higher than that in the C4d-negative group (3.97 vs. 0.81, P < 0.001), and the average integrated optical density value of each child was positively correlated with the UPCR (r = 0.441, P < 0.001). There was a significant difference in the proportions of children with mesangial hypercellularity (M1) (68.97% vs. 44.44%, P = 0.048) and segmental glomerulosclerosis (S1) (65.52% vs. 33.33%, P = 0.010) between the C4d-positive group and the C4d-negative group. The proportion of children who received immunosuppressants in the C4d-positive group was higher than that in the C4d-negative group (86.21% vs. 36.11%, P < 0.001). There was no significant difference in the proportion of children developing kidney failure between the two groups.ConclusionC4d was found to be associated with proteinuria, segmental lesions, and immunosuppressant treatment. Activation of the lectin pathway may reflect the severity of clinical and pathological manifestations of IgA nephropathy in children.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information. More... »

PAGES

1-11

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URI

http://scigraph.springernature.com/pub.10.1007/s00467-022-05725-9

DOI

http://dx.doi.org/10.1007/s00467-022-05725-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1150995702

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/36102962


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