title: Extraglomerular C3 deposition and metabolic impacts in patients with IgA nephropathy.
abstract: BACKGROUND
  The aim of the present study was to explore the significance of extraglomerular (Bowman's capsule and/or arteriole) C3 (ex-C3) deposits in IgA nephropathy (IgAN).
  
  
  METHODS
  One hundred and seventy patients with IgAN were divided into two groups: Group A (n=79), patients who did not have ex-C3 deposits, and Group B (n=91), patients who had ex-C3 deposits.
  
  
  RESULTS
  At the time of renal biopsy, Group B was characterized by a marked increase in diastolic blood pressure, total cholesterol, triglyceride and low-density lipoprotein-cholesterol compared with those of Group A. After 4 years, the estimated glomerular filtration rate (eGFR) in Group B was significantly worse than that of Group A. Upon examination by electron microscopy, the arteriolar dense deposits in Group B were found to occur in significantly higher amounts than in Group A. One hundred and thirty-four patients underwent a 3-year follow-up study after intervention and were re-divided by therapeutic factors as follows: 'conventional therapy', treatment with anti-hypertensive drugs and/or anti-platelet drugs, and 'aggressive therapy', additional treatment with either tonsillectomy or corticosteroid. Patients treated with conventional therapy in Group B had significantly higher body mass index and levels of C3 and CH50 compared with other Groups. Aggressive therapy was significantly effective in urinary protein reduction in both Group A and Group B. Except for the patients who received aggressive therapy in Group A, the levels of the eGFR gradually declined.
  
  
  CONCLUSIONS
  It appears that IgAN patients who have ex-C3 deposits have worse clinical outcomes.
authors: Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors: Isao
authors: I
authors: Ohsawa
authors: Gaku
authors: G
authors: Kusaba
authors: Masaya
authors: M
authors: Ishii
authors: Nobuyuki
authors: N
authors: Sato
authors: Hiroyuki
authors: H
authors: Inoshita
authors: Kisara
authors: K
authors: Onda
authors: Azusa
authors: A
authors: Hashimoto
authors: Seiji
authors: S
authors: Nagamachi
authors: Hiyori
authors: H
authors: Suzuki
authors: Mamiko
authors: M
authors: Shimamoto
authors: Hiroyuki
authors: H
authors: Ohi
authors: Satoshi
authors: S
authors: Horikoshi
authors: Yasuhiko
authors: Y
authors: Tomino
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D003176:Complement C3 / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005920:Glomerular Mesangium / Q000378:metabolism / Q000473:pathology*; D005922:Glomerulonephritis, IGA / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003176:Complement C3