title: Positive C1q staining associated with poor renal outcome in membranoproliferative glomerulonephritis.
abstract: BACKGROUND
  Pathogenesis and clinical prognosis of membranoproliferative glomerulonephritis (MPGN) has not yet been established.
  
  
  METHODS
  We conducted a retrospective study of 41 patients with MPGN (type I and III) and examined the renal survival. In addition, factors contributing to survival time were analyzed.
  
  
  RESULTS
  Fourteen patients (34 %) were classified into the renal death group. Patients with nephrotic syndrome and positive C1q staining of glomerular deposits showed a particularly poor prognosis. Significantly higher frequency of nephrotic syndrome and higher urinary protein excretion were observed in the renal death group (p = 0.0002, p = 0.0002) than in the renal survival group. The intensity of C1q staining was positively correlated with the severity of the proteinuria (p = 0.004). Factors that influenced the survival time were positive C1q staining of glomerular deposits (p = 0.003), presence of nephrotic syndrome (p = 0.004), serum albumin (p = 0.02), and proteinuria (p = 0.04).
  
  
  CONCLUSIONS
  C1q staining in glomerular deposits and nephrotic syndrome were important factors influencing the prognosis and outcome in MPGN patients. C1q deposition may play a key role in the pathogenesis of MPGN, as evidenced by numerous observations, such as induction of proteinuria.
authors: Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. ttakei@kc.twmu.ac.jp
authors: Takashi
authors: T
authors: Takei
authors: Mitsuyo
authors: M
authors: Itabashi
authors: Takahito
authors: T
authors: Moriyama
authors: Ari
authors: A
authors: Shimizu
authors: Yuki
authors: Y
authors: Tsuruta
authors: Ayami
authors: A
authors: Ochi
authors: Kayu
authors: K
authors: Nakayama
authors: Chihiro
authors: C
authors: Iwasaki
authors: Keiko
authors: K
authors: Uchida
authors: Kosaku
authors: K
authors: Nitta
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D016009:Chi-Square Distribution; D015922:Complement C1q / Q000032:analysis*; D018450:Disease Progression; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000276:immunology; D007678:Kidney Glomerulus / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000276:immunology; D011507:Proteinuria / Q000276:immunology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D007166:Immunosuppressive Agents; D015922:Complement C1q