Title :

Prognostic value of complement serum C3 level and glomerular C3 deposits in anti-glomerular basement membrane disease.

Author(s) :

Caillard, Pauline [Auteur]
Université de Picardie Jules Verne [UPJV]
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
Vigneau, Cécile [Auteur]
École des Hautes Études en Santé Publique [EHESP] [EHESP]
Halimi, Jean-Michel [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Hazzan, Marc [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Thervet, Eric [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Heitz, Morgane [Auteur]
Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
Juillard, Laurent [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Audard, Vincent [Auteur]
Hôpital Henri Mondor
Rabant, Marion [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Hertig, Alexandre [Auteur]
Hôpital Foch [Suresnes]
Subra, Jean-François [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Vuiblet, Vincent [Auteur]
Hôpital universitaire Robert Debré [Reims] [CHU Reims]
Guerrot, Dominique [Auteur]
CHU Rouen
Tamain, Mathilde [Auteur]
Essig, Marie [Auteur]
Hôpital Ambroise Paré [AP-HP]
Lobbedez, Thierry [Auteur]
CHU Caen
Quemeneur, Thomas [Auteur]
Centre hospitalier [Valenciennes, Nord]
Legendre, Mathieu [Auteur]
Service de néphrologie (CHU de Dijon)
Ganea, Alexandre [Auteur]
Centre Hospitalier Régional d'Orléans [CHRO]
Peraldi, Marie-Noëlle [Auteur]
Institut Necker Enfants-Malades [INEM - UM 111 (UMR 8253 / U1151)]
Daroux, Maïté [Auteur]
Centre Hospitalier Boulogne-sur-mer
Makdassi, Raifah [Auteur]
Université de Picardie Jules Verne [UPJV]
Choukroun, Gabriel [Auteur]
Université de Picardie Jules Verne [UPJV]
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
Titeca-Beauport, Dimitri [Auteur]
Université de Picardie Jules Verne [UPJV]
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]

Journal title :

Front Immunol

Abbreviated title :

Front Immunol

Volume number :

14

Pages :

1190394

Publication date :

2023-07-26

ISSN :

1664-3224

English keyword(s) :

anti-glomerular basement membrane disease
complement C3
C3 glomerular deposits
kidney biopsy
kidney prognosis
kidney survival

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background and objectives: Activation of the complement system is involved in the pathogenesis of anti-glomerular basement membrane (anti-GBM) disease. Glomerular deposits of complement 3 (C3) are often detected on kidney ...
Show more >Background and objectives: Activation of the complement system is involved in the pathogenesis of anti-glomerular basement membrane (anti-GBM) disease. Glomerular deposits of complement 3 (C3) are often detected on kidney biopsies. The primary objective of this study was to analyze the prognostic value of the serum C3 level and the presence of C3 glomerular deposits in patients with anti-GBM disease. Methods: We conducted a retrospective cohort study of 150 single-positive patients with anti-GBM disease diagnosed between 1997 and 2017. Patients were categorized according to the serum C3 level (forming a low C3 (C3<1.23 g/L) and a high C3 (C3≥1.23 g/L) groups) and positivity for C3 glomerular staining (forming the C3+ and C3- groups). The main outcomes were kidney survival and patient survival. Results: Of the 150 patients included, 89 (65%) were men. The median [interquartile range (IQR)] age was 45 [26–64]. At diagnosis, kidney involvement was characterized by a median [IQR] peak serum creatinine (SCr) level of 578 [298–977] µmol/L, and 106 (71%) patients required dialysis. Patients in the low C3 group (72 patients) had more severe kidney disease at presentation, as characterized by higher prevalences of oligoanuria, peak SCr ≥500 µmol/L (69%, vs. 53% in the high C3 group; p=0.03), nephrotic syndrome (42%, vs. 24%, respectively; p=0.02) and fibrous forms on the kidney biopsy (21%, vs. 8%, respectively; p=0.04). Similarly, we observed a negative association between the presence of C3 glomerular deposits (in 52 (41%) patients) and the prevalence of cellular forms (83%, vs. 58% in the C3- group; p=0.003) and acute tubulo-interstitial lesions (60%, vs. 36% in the C3- group; p=0.007). When considering patients not on dialysis at diagnosis, the kidney survival rate at 12 months was poorer in the C3+ group (50% [25-76], vs. 91% [78-100] in the C3- group; p=0.01), with a hazard ratio [95% confidence interval] of 5.71 [1.13-28.85] (p=0.04, after adjusting for SCr). Conclusion: In patients with anti-GBM disease, a low serum C3 level and the presence of C3 glomerular deposits were associated with more severe disease and histological kidney involvement at diagnosis. In patients not on dialysis at diagnosis, the presence of C3 deposits was associated with worse kidney survival.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T22:23:54Z
2024-03-04T10:25:45Z