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Severe glomerular C3 deposition indicated severe renal lesions and poor prognosis in patients with Immunoglobulin A Nephropathy
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  • jianliang wu,
  • Zhizhi Hu,
  • Yuxi Wang ,
  • Danni Hu,
  • Qian Yang,
  • Yueqiang Li,
  • Wei Dai,
  • Fengming Zhu,
  • Juan Yang,
  • Meng Wang,
  • Han Zhu,
  • Liu Liu,
  • Xiaofeng He,
  • Min Han,
  • Ying Yao,
  • Guangchang Pei,
  • Rui Zeng,
  • Gang Xu
jianliang wu
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Zhizhi Hu
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Yuxi Wang
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Danni Hu
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Qian Yang
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Yueqiang Li
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Wei Dai
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Fengming Zhu
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Juan Yang
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Meng Wang
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Han Zhu
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Liu Liu
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Xiaofeng He
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Min Han
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Ying Yao
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Guangchang Pei
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Rui Zeng
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Huazhong University of Science & Technology
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Gang Xu
Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Abstract

ABSTRACT Background and objectives Glomerular C3 deposition is often observed in renal biopsies of patients with IgA nephropathy (IgAN), however, the relationship between the level of C3 deposition and the long-term prognosis of IgAN have rarely been reported. In this observational cohort study, we aimed to evaluate the prognostic value of glomerular C3 deposition in the progression of IgAN. Materials and Methods From June 2009 to June 2010, a total of 136 adult patients with IgAN were enrolled in the study. Glomerular deposition of the complement protein C3, immune complexes, and inflammatory cells were detected in renal biopsy tissue. The level of renal lesions, glomerular immune complexes, and the density of interstitial inflammatory cells were analyzed. Based on an average of 105 months of follow-up, the predictive value of glomerular C3 deposition for IgAN progression was investigated. Results Of the 136 patients, 102 patients were classified into the glomerular C3low group and 34 patients were classified into the glomerular C3high group. Patients in C3high group had more immune complexes deposition than those in C3low group. In C3high group, the degree of renal lesion and interstitial fibrosis were severer compared to C3low group. Renal biopsy in C3high group presented with higher density of interstitial inflammatory cells that in C3low group. The density of glomerular C3 deposition was associated with poor renal survival over a 105-month follow-up. Conclusions The high density of glomerular C3 deposition was associated with severity of renal lesions and predicted a long-term poor renal survival for IgAN patients.