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Mesangial C4d deposition may predict progression of kidney disease in pediatric patients with IgA nephropathy

Background Data on the risk factors for chronic kidney disease in children with immunoglobulin A nephropathy (IgAN) are scarce. This study was aimed at investigating whether glomerular C4d immunostaining is a prognostic marker in pediatric IgAN. Methods In this retrospective cohort study, 47 patient... Full description

Journal Title: Pediatric nephrology (Berlin West), 2017-02-23, Vol.32 (7), p.1211-1220
Main Author: Fabiano, Rafaela Cabral Gonçalves
Other Authors: de Almeida Araújo, Stanley , Bambirra, Eduardo Alves , Oliveira, Eduardo Araújo , Simões e Silva, Ana Cristina , Pinheiro, Sérgio Veloso Brant
Format: Electronic Article Electronic Article
Language: English
Subjects:
Biological markers
Biomarkers - analysis
Biomarkers - metabolism
Biopsy
Child
Children
Chronic kidney failure
Complement C4b - analysis
Complement C4b - metabolism
Complications and side effects
Development and progression
Disease Progression
End-stage renal disease
Epidermal growth factor receptors
Female
Follow-Up Studies
Glomerular Filtration Rate
Glomerular Mesangium - metabolism
Glomerular Mesangium - pathology
Glomerulonephritis, IGA - pathology
Glomerulonephritis, IGA - urine
Health aspects
Humans
IgA nephropathy
Immunoglobulin A
Immunohistochemistry
Kidney diseases
Kidney Failure, Chronic - pathology
Kidney Failure, Chronic - urine
Kidney transplantation
Male
Medicine
Medicine & Public Health
Nephrology
Original Article
Pediatric research
Pediatrics
Peptide Fragments - analysis
Peptide Fragments - metabolism
Prognosis
Proteinuria
Proteinuria - urine
Renal function
Retrospective Studies
Risk Factors
Survival
Urology
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/28233100
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title: Mesangial C4d deposition may predict progression of kidney disease in pediatric patients with IgA nephropathy
format: Article
creator:
  • Fabiano, Rafaela Cabral Gonçalves
  • de Almeida Araújo, Stanley
  • Bambirra, Eduardo Alves
  • Oliveira, Eduardo Araújo
  • Simões e Silva, Ana Cristina
  • Pinheiro, Sérgio Veloso Brant
subjects:
  • Biological markers
  • Biomarkers - analysis
  • Biomarkers - metabolism
  • Biopsy
  • Child
  • Children
  • Chronic kidney failure
  • Complement C4b - analysis
  • Complement C4b - metabolism
  • Complications and side effects
  • Development and progression
  • Disease Progression
  • End-stage renal disease
  • Epidermal growth factor receptors
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Glomerular Mesangium - metabolism
  • Glomerular Mesangium - pathology
  • Glomerulonephritis, IGA - pathology
  • Glomerulonephritis, IGA - urine
  • Health aspects
  • Humans
  • IgA nephropathy
  • Immunoglobulin A
  • Immunohistochemistry
  • Kidney diseases
  • Kidney Failure, Chronic - pathology
  • Kidney Failure, Chronic - urine
  • Kidney transplantation
  • Male
  • Medicine
  • Medicine & Public Health
  • Nephrology
  • Original Article
  • Pediatric research
  • Pediatrics
  • Peptide Fragments - analysis
  • Peptide Fragments - metabolism
  • Prognosis
  • Proteinuria
  • Proteinuria - urine
  • Renal function
  • Retrospective Studies
  • Risk Factors
  • Survival
  • Urology
ispartof: Pediatric nephrology (Berlin, West), 2017-02-23, Vol.32 (7), p.1211-1220
description: Background Data on the risk factors for chronic kidney disease in children with immunoglobulin A nephropathy (IgAN) are scarce. This study was aimed at investigating whether glomerular C4d immunostaining is a prognostic marker in pediatric IgAN. Methods In this retrospective cohort study, 47 patients with IgAN biopsied from 1982 to 2010 were evaluated. Immunohistochemistry for C4d was performed in all cases. For analysis, patients were grouped according to positivity or not for C4d in the mesangial area. Primary outcome was a decline in baseline estimated glomerular filtration rate (eGFR) by 50% or more. Results Median follow-up was 8.3 years. Median renal survival was 13.7 years and the probability of a 50% decline in eGFR was 13% over 10 years. Nine children exhibited the primary outcome and 4 developed end-stage renal disease (ESRD). Compared with C4d-negative patients ( n  = 10), C4d-positive patients ( n  = 37) presented higher baseline proteinuria (1.66 ± 0.68 vs 0.47 ± 0.19 g/day/1.73 m 2 , p  
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titleMesangial C4d deposition may predict progression of kidney disease in pediatric patients with IgA nephropathy
creatorFabiano, Rafaela Cabral Gonçalves ; de Almeida Araújo, Stanley ; Bambirra, Eduardo Alves ; Oliveira, Eduardo Araújo ; Simões e Silva, Ana Cristina ; Pinheiro, Sérgio Veloso Brant
creatorcontribFabiano, Rafaela Cabral Gonçalves ; de Almeida Araújo, Stanley ; Bambirra, Eduardo Alves ; Oliveira, Eduardo Araújo ; Simões e Silva, Ana Cristina ; Pinheiro, Sérgio Veloso Brant
descriptionBackground Data on the risk factors for chronic kidney disease in children with immunoglobulin A nephropathy (IgAN) are scarce. This study was aimed at investigating whether glomerular C4d immunostaining is a prognostic marker in pediatric IgAN. Methods In this retrospective cohort study, 47 patients with IgAN biopsied from 1982 to 2010 were evaluated. Immunohistochemistry for C4d was performed in all cases. For analysis, patients were grouped according to positivity or not for C4d in the mesangial area. Primary outcome was a decline in baseline estimated glomerular filtration rate (eGFR) by 50% or more. Results Median follow-up was 8.3 years. Median renal survival was 13.7 years and the probability of a 50% decline in eGFR was 13% over 10 years. Nine children exhibited the primary outcome and 4 developed end-stage renal disease (ESRD). Compared with C4d-negative patients ( n  = 10), C4d-positive patients ( n  = 37) presented higher baseline proteinuria (1.66 ± 0.68 vs 0.47 ± 0.19 g/day/1.73 m 2 , p  < 0.001), a progressive decline in eGFR (−10.04 ± 19.38 vs 1.70 ± 18.51 ml/min/1.73 m 2 /year; p  = 0.045), and more frequently achieved the primary outcome (50.0 vs 10.8%, p  = 0.013), and ESRD (30.0 vs 2.7%, p  = 0.026). No difference was observed in Oxford classification variables. Baseline proteinuria, endocapillary hypercellularity and mesangial C4d deposition were associated with primary outcome in univariate analysis. Proteinuria and mesangial C4d deposition at baseline independently predicted the decline in eGFR. Renal survival was significantly reduced in C4d-positive patients (8.6 vs 15.1 years in C4d-negative patients, p  < 0.001). Conclusions In this exclusively pediatric cohort, positivity for C4d in the mesangial area was an independent predictor of renal function deterioration in IgAN.
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1EISSN: 1432-198X
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languageeng
publisherBerlin/Heidelberg: Springer Berlin Heidelberg
subjectBiological markers ; Biomarkers - analysis ; Biomarkers - metabolism ; Biopsy ; Child ; Children ; Chronic kidney failure ; Complement C4b - analysis ; Complement C4b - metabolism ; Complications and side effects ; Development and progression ; Disease Progression ; End-stage renal disease ; Epidermal growth factor receptors ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Glomerular Mesangium - metabolism ; Glomerular Mesangium - pathology ; Glomerulonephritis, IGA - pathology ; Glomerulonephritis, IGA - urine ; Health aspects ; Humans ; IgA nephropathy ; Immunoglobulin A ; Immunohistochemistry ; Kidney diseases ; Kidney Failure, Chronic - pathology ; Kidney Failure, Chronic - urine ; Kidney transplantation ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Pediatric research ; Pediatrics ; Peptide Fragments - analysis ; Peptide Fragments - metabolism ; Prognosis ; Proteinuria ; Proteinuria - urine ; Renal function ; Retrospective Studies ; Risk Factors ; Survival ; Urology
ispartofPediatric nephrology (Berlin, West), 2017-02-23, Vol.32 (7), p.1211-1220
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2Pediatric Nephrology is a copyright of Springer, 2017.
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0Fabiano, Rafaela Cabral Gonçalves
1de Almeida Araújo, Stanley
2Bambirra, Eduardo Alves
3Oliveira, Eduardo Araújo
4Simões e Silva, Ana Cristina
5Pinheiro, Sérgio Veloso Brant
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0Mesangial C4d deposition may predict progression of kidney disease in pediatric patients with IgA nephropathy
1Pediatric nephrology (Berlin, West)
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descriptionBackground Data on the risk factors for chronic kidney disease in children with immunoglobulin A nephropathy (IgAN) are scarce. This study was aimed at investigating whether glomerular C4d immunostaining is a prognostic marker in pediatric IgAN. Methods In this retrospective cohort study, 47 patients with IgAN biopsied from 1982 to 2010 were evaluated. Immunohistochemistry for C4d was performed in all cases. For analysis, patients were grouped according to positivity or not for C4d in the mesangial area. Primary outcome was a decline in baseline estimated glomerular filtration rate (eGFR) by 50% or more. Results Median follow-up was 8.3 years. Median renal survival was 13.7 years and the probability of a 50% decline in eGFR was 13% over 10 years. Nine children exhibited the primary outcome and 4 developed end-stage renal disease (ESRD). Compared with C4d-negative patients ( n  = 10), C4d-positive patients ( n  = 37) presented higher baseline proteinuria (1.66 ± 0.68 vs 0.47 ± 0.19 g/day/1.73 m 2 , p  < 0.001), a progressive decline in eGFR (−10.04 ± 19.38 vs 1.70 ± 18.51 ml/min/1.73 m 2 /year; p  = 0.045), and more frequently achieved the primary outcome (50.0 vs 10.8%, p  = 0.013), and ESRD (30.0 vs 2.7%, p  = 0.026). No difference was observed in Oxford classification variables. Baseline proteinuria, endocapillary hypercellularity and mesangial C4d deposition were associated with primary outcome in univariate analysis. Proteinuria and mesangial C4d deposition at baseline independently predicted the decline in eGFR. Renal survival was significantly reduced in C4d-positive patients (8.6 vs 15.1 years in C4d-negative patients, p  < 0.001). Conclusions In this exclusively pediatric cohort, positivity for C4d in the mesangial area was an independent predictor of renal function deterioration in IgAN.
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1Biomarkers - analysis
2Biomarkers - metabolism
3Biopsy
4Child
5Children
6Chronic kidney failure
7Complement C4b - analysis
8Complement C4b - metabolism
9Complications and side effects
10Development and progression
11Disease Progression
12End-stage renal disease
13Epidermal growth factor receptors
14Female
15Follow-Up Studies
16Glomerular Filtration Rate
17Glomerular Mesangium - metabolism
18Glomerular Mesangium - pathology
19Glomerulonephritis, IGA - pathology
20Glomerulonephritis, IGA - urine
21Health aspects
22Humans
23IgA nephropathy
24Immunoglobulin A
25Immunohistochemistry
26Kidney diseases
27Kidney Failure, Chronic - pathology
28Kidney Failure, Chronic - urine
29Kidney transplantation
30Male
31Medicine
32Medicine & Public Health
33Nephrology
34Original Article
35Pediatric research
36Pediatrics
37Peptide Fragments - analysis
38Peptide Fragments - metabolism
39Prognosis
40Proteinuria
41Proteinuria - urine
42Renal function
43Retrospective Studies
44Risk Factors
45Survival
46Urology
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titleMesangial C4d deposition may predict progression of kidney disease in pediatric patients with IgA nephropathy
authorFabiano, Rafaela Cabral Gonçalves ; de Almeida Araújo, Stanley ; Bambirra, Eduardo Alves ; Oliveira, Eduardo Araújo ; Simões e Silva, Ana Cristina ; Pinheiro, Sérgio Veloso Brant
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0Biological markers
1Biomarkers - analysis
2Biomarkers - metabolism
3Biopsy
4Child
5Children
6Chronic kidney failure
7Complement C4b - analysis
8Complement C4b - metabolism
9Complications and side effects
10Development and progression
11Disease Progression
12End-stage renal disease
13Epidermal growth factor receptors
14Female
15Follow-Up Studies
16Glomerular Filtration Rate
17Glomerular Mesangium - metabolism
18Glomerular Mesangium - pathology
19Glomerulonephritis, IGA - pathology
20Glomerulonephritis, IGA - urine
21Health aspects
22Humans
23IgA nephropathy
24Immunoglobulin A
25Immunohistochemistry
26Kidney diseases
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36Pediatrics
37Peptide Fragments - analysis
38Peptide Fragments - metabolism
39Prognosis
40Proteinuria
41Proteinuria - urine
42Renal function
43Retrospective Studies
44Risk Factors
45Survival
46Urology
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1de Almeida Araújo, Stanley
2Bambirra, Eduardo Alves
3Oliveira, Eduardo Araújo
4Simões e Silva, Ana Cristina
5Pinheiro, Sérgio Veloso Brant
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jtitlePediatric nephrology (Berlin, West)
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0Fabiano, Rafaela Cabral Gonçalves
1de Almeida Araújo, Stanley
2Bambirra, Eduardo Alves
3Oliveira, Eduardo Araújo
4Simões e Silva, Ana Cristina
5Pinheiro, Sérgio Veloso Brant
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atitleMesangial C4d deposition may predict progression of kidney disease in pediatric patients with IgA nephropathy
jtitlePediatric nephrology (Berlin, West)
stitlePediatr Nephrol
addtitlePediatr Nephrol
date2017-02-23
risdate2017
volume32
issue7
spage1211
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pages1211-1220
issn0931-041X
eissn1432-198X
abstractBackground Data on the risk factors for chronic kidney disease in children with immunoglobulin A nephropathy (IgAN) are scarce. This study was aimed at investigating whether glomerular C4d immunostaining is a prognostic marker in pediatric IgAN. Methods In this retrospective cohort study, 47 patients with IgAN biopsied from 1982 to 2010 were evaluated. Immunohistochemistry for C4d was performed in all cases. For analysis, patients were grouped according to positivity or not for C4d in the mesangial area. Primary outcome was a decline in baseline estimated glomerular filtration rate (eGFR) by 50% or more. Results Median follow-up was 8.3 years. Median renal survival was 13.7 years and the probability of a 50% decline in eGFR was 13% over 10 years. Nine children exhibited the primary outcome and 4 developed end-stage renal disease (ESRD). Compared with C4d-negative patients ( n  = 10), C4d-positive patients ( n  = 37) presented higher baseline proteinuria (1.66 ± 0.68 vs 0.47 ± 0.19 g/day/1.73 m 2 , p  < 0.001), a progressive decline in eGFR (−10.04 ± 19.38 vs 1.70 ± 18.51 ml/min/1.73 m 2 /year; p  = 0.045), and more frequently achieved the primary outcome (50.0 vs 10.8%, p  = 0.013), and ESRD (30.0 vs 2.7%, p  = 0.026). No difference was observed in Oxford classification variables. Baseline proteinuria, endocapillary hypercellularity and mesangial C4d deposition were associated with primary outcome in univariate analysis. Proteinuria and mesangial C4d deposition at baseline independently predicted the decline in eGFR. Renal survival was significantly reduced in C4d-positive patients (8.6 vs 15.1 years in C4d-negative patients, p  < 0.001). Conclusions In this exclusively pediatric cohort, positivity for C4d in the mesangial area was an independent predictor of renal function deterioration in IgAN.
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid28233100
doi10.1007/s00467-017-3610-y