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Circulating C3 levels predict renal and global outcome in patients with renal vasculitis

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Abstract

Several studies have demonstrated the crucial role of complement activation in the pathogenesis of ANCA-associated vasculitis. We aimed to assess the association between baseline serum C3 (sC3) levels and long-term outcomes in patients with renal vasculitis. This retrospective study included 111 patients with renal vasculitis from three hospitals who underwent a renal biopsy between 1997 and 2014. Serum levels of C3 were measured at the onset and the study population was divided into three tertiles according to sC3 concentrations (tertile 1 <106 mg/dl; tertile 2 106–128 mg/dl; tertile 3 >128 mg/dl). Patients with lower sC3 (tertile 1) were compared with those having higher levels of sC3 (tertile 2 and tertile 3). Histological, clinical, and laboratory data were recorded for analysis. The primary end point was the composite of end-stage renal disease (ESRD) and death from any cause. Lower sC3 levels were associated with a higher need for dialysis and lower response rate to treatment (p = 0.04 and p = 0.007, respectively). Renal and global survival at 1 and 5 years was 53 and 46 % in patients with lower sC3 (tertile 1) compared with 72 and 65 % in patients with higher sC3 (upper two tertiles) (p = 0.04). In a multivariate Cox-regression model, when adjusted by renal function and histopatholologic categories, lower sC3 remained as an independent predictor of ESRD and death (HR, 1.9; 95 % CI, 1.1 to 3.4; p = 0.02). Baseline serum C3 levels have an independent prognostic value in predicting long-term renal and global survival in patients with renal vasculitis.

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Acknowledgments

We thank Elia Pérez from the Statistical Unit of Hospital Fundacion Alcorcon for her help with data analysis.

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Authors and Affiliations

  1. Nephrology Department, Hospital Universitario Fundacion, Alcorcon, Spain

    Javier Villacorta & Gema Fernandez-Juarez

  2. Pathology Department, Hospital Virgen de la Salud, Toledo, Spain

    Francisco Diaz-Crespo

  3. Nephrology Department, Hospital Virgen de la Salud, Toledo, Spain

    Mercedes Acevedo

  4. Nephrology Department, Hospital Universitario Doce de Octubre, Madrid, Spain

    Teresa Cavero & Manuel Praga

  5. Pathology Department, Hospital Universitario Fundacion, Alcorcon, Spain

    Carmen Guerrero

Authors
  1. Javier Villacorta
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  2. Francisco Diaz-Crespo
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  3. Mercedes Acevedo
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  4. Teresa Cavero
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  5. Carmen Guerrero
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  6. Manuel Praga
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  7. Gema Fernandez-Juarez
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Correspondence to Javier Villacorta.

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Villacorta, J., Diaz-Crespo, F., Acevedo, M. et al. Circulating C3 levels predict renal and global outcome in patients with renal vasculitis. Clin Rheumatol 35, 2733–2740 (2016). https://doi.org/10.1007/s10067-016-3384-9

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  • DOI: https://doi.org/10.1007/s10067-016-3384-9

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