Decreased Serum C3 Levels in Immunoglobulin A (IgA) Nephropathy with Chronic Kidney Disease: A Propensity Score Matching Study.
Decreased Serum C3 Levels in Immunoglobulin A (IgA) Nephropathy with Chronic Kidney Disease: A Propensity Score Matching Study.
复制标题
慢性肾脏病免疫球蛋白 A (IgA) 肾病血清 C3 水平降低：倾向评分匹配研究
DOI：
10.12659/msm.903102
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发表时间：
2017-02-06
期刊：
影响因子：
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通讯作者：
Chen XM
中科院分区：
文献类型：
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作者：
Yang X;Wei RB;Wang Y;Su TY;Li QP;Yang T;Huang MJ;Li KY;Chen XM
背景低血清C3水平和补体系统激活对IgAN的发生和预后的影响尚不清楚。本研究旨在确定补体C3水平降低是否影响慢性肾脏病IgAN患者的预后。材料/方法我们纳入了2011年1月至2015年3月在解放军总医院接受肾活检诊断的1564例原发性IgAN患者。终点为终末期肾病（ESRD）或基线血清肌酐（D-SCr）水平加倍。所有患者均使用1：1倾向评分匹配（PSM），两组基线值差异无统计学意义（P> 0.05）。结果随访期间，C3水平下降组中14例达到终点，12例C3水平正常。两组在达到D-SCr或ESRD方面无显著差异（P = 0.676）。在多变量考克斯分析中，调整人口统计学和实验室检查，两组达到终点的风险相当（HR，0.70; 95% CI，0.27 - 1.78; P = 0.449;）。此外，两组之间达到ESRD（HR，0.83; 95% CI，0.25 - 2.75; P = 0.757）和D-SCr（HR，1.45; 95% CI，0.20 - 10.60; P = 0.718）的风险没有差异。结论IgA肾病合并慢性肾脏病患者血清C3水平降低对肾脏疾病进展无决定性作用。
Background The effects of low serum C3 levels and the activation of the complement system on the development and the prognosis of IgAN are unclear. The present study aimed to determine whether decreased levels of complement C3 influence the prognosis of IgAN patients with chronic kidney disease. Material/Methods We enrolled a total of 1564 patients with primary IgAN diagnosed by renal biopsy at the Chinese PLA General Hospital from January 2011 to March 2015. The endpoint was end-stage renal disease (ESRD) or a doubling of the baseline serum creatinine (D-SCr) level. All patients were using 1: 1 propensity score matching (PSM), and the baseline values were not significantly different between these 2 groups (P>0.05). Results During a follow-up period, 14 patients in the group with decreased C3 levels reached the endpoint, with 12 patients with normal C3 levels. There was no significant difference between the 2 groups in achieving D-SCr or ESRD (P=0.676). In multivariate Cox analysis, adjusted for demographic and laboratory examination, the risk of reaching the endpoint was comparable in the 2 groups (HR, 0.70; 95% CI, 0.27–1.78; P=0.449;). Furthermore, the risk of reaching ESRD (HR, 0.83; 95% CI, 0.25–2.75; P=0.757) and D-SCr (HR, 1.45; 95% CI, 0.20–10.60; P=0.718) did not differ between the 2 groups. Conclusions Decreased serum C3 levels in IgA nephropathy with chronic kidney disease did not play a decisive role in renal progression.