Demographic, clinical characteristics and treatment outcomes of immune-complex membranoproliferative glomerulonephritis and C3 glomerulonephritis in Japan: A retrospective analysis of data from the Japan Renal Biopsy Registry

Naoki Nakagawa, Masashi Mizuno, Sawako Kato, Shoichi Maruyama, Hiroshi Sato, Izaya Nakaya, Hitoshi Sugiyama, Shouichi Fujimoto, Kenichiro Miura, Chieko Matsumura, Yoshimitsu Gotoh, Hitoshi Suzuki, Aki Kuroki, Atsunori Yoshino, Shinya Nakatani, Keiju Hiromura, Ryohei Yamamoto, Hitoshi Yokoyama, Ichiei Narita, Yoshitaka Isaka

Research output: Contribution to journalReview articlepeer-review

Abstract

The reclassification of membranoproliferative glomerulonephritis (MPGN) into immune-complex MPGN (IC-MPGN) and C3 glomerulopathy (C3G) based on immunofluorescence findings in kidney biopsies has provided insights into these two distinct diseases. C3G is further classified into dense deposit disease and C3 glomerulonephritis (C3GN) based on electron micrographic findings. Although these diseases have poor outcomes, limited Japanese literature confined to small, single-center cohorts exist on these diseases. We retrospectively analyzed 81 patients with MPGN type I and III from 15 hospitals in the Japan Renal Biopsy Registry to compare demographic, clinical characteristics and treatment outcomes of patients with IC-MPGN to those with C3GN. Of the 81 patients reviewed by immunofluorescence findings in kidney biopsies, 67 patients had IC-MPGN and 14 patients had C3GN. Age at diagnosis and systolic and diastolic pressure were higher and proteinuria and impaired renal function were significantly more prevalent in patients with IC-MPGN than those with C3GN. About 80% of the patients in both groups were treated with immunosuppressive therapy. At last follow-up (median 4.8 years), complete remission rate of proteinuria was significantly higher in patients with C3GN (64.3%) than in those with IC-MPGN (29.9%; P = 0.015). The renal survival rate was lower in patients with IC-MPGN when compared to C3GN (73.1% vs. 100%; log-rank, P = 0.031). Systolic blood pressure and renal function at baseline were independent predictors of progression to end-stage kidney disease. The overall prognosis of patients with C3GN is more favorable than for patients with IC-MPGN.

Original languageEnglish
Article numbere0257397
JournalPloS one
Volume16
Issue number9 September 2021
DOIs
Publication statusPublished - Sep 2021

ASJC Scopus subject areas

  • General

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