Atıf İçin Kopyala
Mirioglu S., Cebeci E., Yazici H., Derici U., Sahin G. M., Eren N., ...Daha Fazla
NEPHROLOGY DIALYSIS TRANSPLANTATION, cilt.38, sa.Supplement_1, ss.633093, 2023 (Scopus)
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Yayın Türü:
Makale / Tam Makale
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Cilt numarası:
38
Sayı:
Supplement_1
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Basım Tarihi:
2023
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Doi Numarası:
10.1093/ndt/gfad063c_3093
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Dergi Adı:
NEPHROLOGY DIALYSIS TRANSPLANTATION
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Derginin Tarandığı İndeksler:
Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, MEDLINE, Veterinary Science Database
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Sayfa Sayıları:
ss.633093
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Kocaeli Üniversitesi Adresli:
Evet
Özet
Abstract
Background and Aims
Data on prognostic factors of C3 glomerulopathy (C3G) are limited, and validation of the new C3G histologic index (C3G-HI) in different settings is still needed. We aimed to evaluate the chronicity score of C3G-HI and probable prognostic factors in our population.
Methods
In this prospective registry, 99 patients with C3G were identified, and 74 patients from 20 centers with adequate follow-up data were included. Total chronicity score (TCS) (0-10) was calculated according to percentages of glomerulosclerosis, interstitial fibrosis (IF), tubular atrophy (TA), and presence of arterio- and arteriolosclerosis [1]. Study outcome was defined as doubling of serum creatinine from baseline, undergoing dialysis or transplantation, development of stage 5 chronic kidney disease (eGFR <15 ml/min/1.73 m2 by CKD-EPI 2009 equation), or death.
Results
Baseline features, treatment characteristics and outcomes were detailed in Table 1. Median follow-up duration was 36 (12-60) months. Overall, 19 patients (25.7%) experienced the study outcome over a median of 24 (6-51) months. Three patients died due to infections (n = 2) and unknown causes (n = 1) including a patient who died shortly after becoming dialysis-dependent. Median TCS was 3 (1-5). Univariate analyses showed that IF, hemoglobin, serum creatinine and serum albumin levels were associated with the outcome, but only grade 3 IF predicted the outcome in multivariate Cox regression (HR: 6.623, 95% CI: 1.269-34.564, p = 0.025). Since the median follow-up was 36 months, separate analyses for the outcome at 3 years were conducted. IF, TA, TCS, hemoglobin, serum creatinine and albumin were associated with the outcome in univariate analyses. In a multivariate Cox regression model encompassing IF, TA, hemoglobin, serum creatinine and albumin, only hemoglobin was identified as a predictor. A second model including TCS instead of IF and TA demonstrated that TCS (HR: 1.288, 1.021-1.626, p = 0.033) and hemoglobin (HR: 0.617, 0.407-0.935, p = 0.023) predicted the study outcome. Kaplan-Meier analysis showed that 3-year kidney survival was lower in patients with TCS ≥4 (72.4%) compared to TCS <4 (91.1%) (p = 0.036) (Figure 1).
Conclusions
TCS ≥4 and lower hemoglobin levels at diagnosis predict the 3-year kidney survival in patients with C3G, which validates the chronicity score of C3G-HI.