Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2021 Mar 9;11(1):5467.
doi: 10.1038/s41598-021-84715-7.

A multicenter, prospective, observational study to determine association of mesangial C1q deposition with renal outcomes in IgA nephropathy

Li Tan  1   2   3 , Yi Tang  1 , Gaiqin Pei  1   3 , Zhengxia Zhong  4   3 , Jiaxing Tan  1   3 , Ling Zhou  5   3 , Dongmei Wen  6   3 , David Sheikh-Hamad  2 , Wei Qin  7
Affiliations
Clinical Trial

A multicenter, prospective, observational study to determine association of mesangial C1q deposition with renal outcomes in IgA nephropathy

Li Tan et al. Sci Rep. .

Abstract

It was reported that histopathologic lesions are risk factors for the progression of IgA Nephropathy (IgAN). The aim of this study was to investigate the relationships between mesangial deposition of C1q and renal outcomes in IgAN. 1071 patients with primary IgAN diagnosed by renal biopsy were enrolled in multiple study centers form January 2013 to January 2017. Patients were divided into two groups: C1q-positive and C1q-negative. Using a 1: 4 propensity score matching (PSM) method identifying age, gender, and treatment modality to minimize confounding factors, 580 matched (out of 926) C1q-negative patients were compared with 145 C1q-positive patients to evaluate severity of baseline clinicopathological features and renal outcome. Kaplan-Meier and Cox proportional hazards analyses were performed to determine whether mesangial C1q deposition is associated with renal outcomes in IgAN. During the follow-up period (41.89 ± 22.85 months), 54 (9.31%) patients in the C1q negative group and 23 (15.86%) patients in C1q positive group reached the endpoint (50% decline of eGFR and/or ESRD or death) respectively (p = 0.01) in the matched cohort. Significantly more patients in C1q negative group achieved complete or partial remission during the follow up period (P = 0.003) both before and after PSM. Three, 5 and 7-year renal survival rates in C1q-positive patients were significantly lower than C1q-negative patients in either unmatched cohort or matched cohort (all p < 0.05). Furthermore, multivariate Cox regression analysis showed that independent risk factors influencing renal survival included Scr, urinary protein, T1-T2 lesion and C1q deposition. Mesangial C1q deposition is a predictor of poor renal survival in IgA nephropathy.Trial registration TCTR, TCTR20140515001. Registered May 15, 2014, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1074 .

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study profile. CKD chronic kidney disease.
Figure 2
Figure 2
Treatment response and renal outcomes in IgAN patients. CR complete remission, PR partial remission, NR no response, ESRD end stage renal disease.
Figure 3
Figure 3
Kaplan–Meier analysis for the probability of composite endpoints.
Figure 4
Figure 4
C1q deposition in the mesangium from negative to 3 + (original magnification × 40).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Wyatt RJ, Julian BA. IgA nephropathy. N. Engl. J. Med. 2013;368:2402–2414. doi: 10.1056/NEJMra1206793. - DOI - PubMed
    1. Glassock RJ. The pathogenesis of IgA nephropathy. Curr. Opin. Nephrol. Hypertens. 2011;20:153–160. doi: 10.1097/MNH.0b013e3283436f5c. - DOI - PubMed
    1. Yu HH, Chiang BL. Diagnosis and classification of IgA nephropathy. Autoimmun. Rev. 2014;13:556–559. doi: 10.1016/j.autrev.2014.01.030. - DOI - PubMed
    1. Sethi S, et al. Mayo clinic/renal pathology society consensus report on pathologic classification, diagnosis, and reporting of GN. J. Am. Soc. Nephrol. JASN. 2016;27:1278–1287. doi: 10.1681/asn.2015060612. - DOI - PMC - PubMed
    1. Chen H, et al. Pathological demography of native patients in a nephrology center in China. Chin. Med. J. 2003;116:1377–1381. - PubMed