#3093 PROGNOSTIC FACTORS AND VALIDATION OF THE HISTOLOGIC CHRONICITY SCORE FOR C3 GLOMERULOPATHY: A REGISTRY ANALYSIS

Medientyp: E-Artikel
Titel: #3093 PROGNOSTIC FACTORS AND VALIDATION OF THE HISTOLOGIC CHRONICITY SCORE FOR C3 GLOMERULOPATHY: A REGISTRY ANALYSIS
Beteiligte: Mirioglu, Safak; Cebeci, Egemen; Yazici, Halil; Derici, Ulver; Sahin, Gulizar Manga; Eren, Necmi; Gungor, Ozkan; Dede, Fatih; Dincer, Mevlut Tamer; Turkmen, Kultigin; Basturk, Taner; Duranay, Murat; Arikan, Izzet Hakki; Tunca, Onur; Elçioğlu, Ömer Celal; Tatar, Erhan; Aydin, Zeki; Oygar, Deren; Demir, Serap; Tanrisev, Mehmet; Kurultak, Ilhan; Oruc, Aysegul; Turkmen, Aydin; Akcay, Omer Faruk; [...]
Erschienen: Oxford University Press (OUP), 2023
Erschienen in: Nephrology Dialysis Transplantation
Sprache: Englisch
DOI: 10.1093/ndt/gfad063c_3093
ISSN: 0931-0509; 1460-2385
Schlagwörter: Transplantation ; Nephrology
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Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background and Aims</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>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 &lt;15 ml/min/1.73 m2 by CKD-EPI 2009 equation), or death.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>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 &lt;4 (91.1%) (p = 0.036) (Figure 1).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec>

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