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Arteriolar C4d in IgA Nephropathy: A Cohort Study.
Bernardo Faria1, Pedro Canão2, Qingqing Cai3
1Nephrology and Infectious Disease R&D Group, INEB, Institute of Investigation and Innovation in Health (i3S), University of Porto, Porto, Portugal; Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Arteriolar C4d (C4dA) deposition in kidney biopsies indicates a higher risk of progressive kidney disease in immunoglobulin A nephropathy (IgAN). This finding suggests C4dA may serve as a valuable biomarker for predicting IgAN progression.
Area of Science:
- Nephrology
- Immunopathology
- Complement System
Background:
- Glomerular C4d (C4dG) indicates lectin pathway activation in IgAN and correlates with kidney damage.
- Vascular lesions in IgAN biopsies with complement deposition are linked to disease progression.
Purpose of the Study:
- To investigate the clinical significance of arteriolar C4d (C4dA) in IgAN kidney biopsy tissue.
- To determine if C4dA is associated with disease progression in IgAN.
Main Methods:
- Retrospective cohort study of 126 adult IgAN patients.
- Immunohistochemistry used to classify C4dG and C4dA deposition.
- Analysis of vascular lesions and association with progressive kidney disease using multivariable Cox regression.
Main Results:
- C4dA was present in 17% of patients and associated with hypertension, arterial intima fibrosis, and chronic microangiopathy.
- Both C4dA and C4dG were significantly associated with progressive kidney disease.
- C4dA remained an independent predictor of progressive kidney disease after adjusting for other factors.
Conclusions:
- Arteriolar C4d (C4dA) is a potential biomarker for predicting disease progression in IgAN.
- Further investigation in larger cohorts is warranted to confirm the predictive value of C4dA.
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