Prognostic factors and validation of the histologic chronicity score for C3 glomerulopathy: a registry analysis


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Mirioglu S., Cebeci E., Yazici H., DERİCİ Ü., Sahin G., ÇOBAN G., ...Daha Fazla

Clinical Kidney Journal, cilt.17, sa.8, 2024 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 8
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1093/ckj/sfae077
  • Dergi Adı: Clinical Kidney Journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
  • Anahtar Kelimeler: anemia, C3 glomerulopathy, chronicity, CKD, prognosis
  • İstanbul Üniversitesi Adresli: Evet

Özet

Background. Data on the prognostic factors for 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 registry study, 74 patients from 20 centers with adequate follow-up data were included. Total chronicity score (TCS) was calculated according to percentages of glomerulosclerosis, interstitial fibrosis, tubular atrophy, and presence of arterio- and arteriolosclerosis. Primary composite outcome was defined as doubling of serum creatinine from baseline, undergoing dialysis or transplantation, development of stage 5 chronic kidney disease, or death. Results. Median age was 34 [interquartile range (IQR) 24–46] years, and 39 patients (52.7%) were male. Median follow-up duration was 36 (IQR 12–60) months, and median TCS was 3 (IQR 1–5). Overall, 19 patients (25.7%) experienced primary composite outcome. Multivariate Cox regression model showed that only hemoglobin [adjusted HR (aHR) 0.67, 95% confidence interval 0.46–0.97, P = .035] predicted primary composite outcome, and TCS fell short of the statistical significance (aHR 1.26, 0.97–1.64, P = .08). Receiver operating characteristic analysis demonstrated that TCS showed an area under the curve value of 0.68 (0.56–0.78, P = .028) in discriminating primary composite outcome at 3 years, and 3-year kidney survival was lower in patients with TCS ≥4 (72.4%) compared with TCS <4 (91.1%) in Kaplan–Meier analysis (P = .036). Conclusions. Low hemoglobin levels predicted dismal outcomes in patients with C3G. TCS ≥4 was associated with a worse 3-year kidney survival, which validated the 3-year prognostic value of the TCS of C3G-HI in our population.