Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 Glomerulopathy
Introduction: C3 glomerulopathy (C3G) and primary immune complex–mediated membranoproliferative glomerulonephritis (IC-MPGN) are rare diseases that share a similar pathogenesis; however, the prognostic significance of proteinuria reduction remains poorly characterized. This study compared the outcom...
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Elsevier
2025-04-01
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| Series: | Kidney International Reports |
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| author | Fernando Caravaca-Fontán Remedios Toledo-Rojas Ana Huerta José Luis Pérez-Canga Patricia Martínez-Miguel Rosa Miquel Iara Da Silva Úrsula Verdalles Macarena Albornoz Carmen Mercedes Durán López Carmen Mon Gema Fernández-Juárez Manuel Praga Teresa Cavero Luis F. Quintana Helena Marco Xoana Barros Natalia Ramos Nuria Rodríguez Mendiola Sonia Cruz Adela Rodríguez Cristina Rabasco Raquel Rodado Loreto Fernández Vanessa Pérez-Gómez Ana Ávila Luis Bravo Natalia Espinosa Natalia Allende Maria Dolores Sanchez de la Nieta Eva Rodríguez Marta Melgosa Ana Huerta Rosa Miquel Carmen Mon Gloria Fraga Alberto de Lorenzo Juliana Draibe Fayna González Amir Shabaka Maria Esperanza López-Rubio María Ángeles Fenollosa Luis Martín-Penagos Santiago Rodríguez de Córdoba Elena Goicoechea de Jorge |
| author_facet | Fernando Caravaca-Fontán Remedios Toledo-Rojas Ana Huerta José Luis Pérez-Canga Patricia Martínez-Miguel Rosa Miquel Iara Da Silva Úrsula Verdalles Macarena Albornoz Carmen Mercedes Durán López Carmen Mon Gema Fernández-Juárez Manuel Praga Teresa Cavero Luis F. Quintana Helena Marco Xoana Barros Natalia Ramos Nuria Rodríguez Mendiola Sonia Cruz Adela Rodríguez Cristina Rabasco Raquel Rodado Loreto Fernández Vanessa Pérez-Gómez Ana Ávila Luis Bravo Natalia Espinosa Natalia Allende Maria Dolores Sanchez de la Nieta Eva Rodríguez Marta Melgosa Ana Huerta Rosa Miquel Carmen Mon Gloria Fraga Alberto de Lorenzo Juliana Draibe Fayna González Amir Shabaka Maria Esperanza López-Rubio María Ángeles Fenollosa Luis Martín-Penagos Santiago Rodríguez de Córdoba Elena Goicoechea de Jorge |
| author_sort | Fernando Caravaca-Fontán |
| collection | DOAJ |
| description | Introduction: C3 glomerulopathy (C3G) and primary immune complex–mediated membranoproliferative glomerulonephritis (IC-MPGN) are rare diseases that share a similar pathogenesis; however, the prognostic significance of proteinuria reduction remains poorly characterized. This study compared the outcomes in C3G and IC-MPGN and assessed the impact of changes in proteinuria on kidney prognosis. Methods: This retrospective, longitudinal, multicenter study used joint linear mixed-effects models to assess proteinuria trajectories, and Cox regression to evaluate their association with kidney failure. In addition, time-averaged proteinuria (TA-P) was calculated to determine its impact on kidney prognosis. Results: The study included 149 patients: 98 with C3G (66%) and 51 with IC-MPGN (34%) with a median age of 35 (interquartile range [IQR]: 22–53) years. During a median follow-up of 65 (IQR: 32–114) months, 44 patients (30%) progressed to kidney failure without differences across C3G or IC-MPGN. A strong association was observed between longitudinal increase in proteinuria and the risk of kidney failure. In addition, a ≥ 50% proteinuria reduction over time was associated with a lower risk of kidney failure (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.46–0.75, P < 0.001). Results were consistent in both C3G and IC-MPGN, and in those with baseline estimated glomerular filtration rate (eGFR) ≥ 30 ml/min per 1.73 m2 and proteinuria ≥ 1 g/d. A ≥30% proteinuria reduction at 6 months or a ≥50% proteinuria reduction at 12 months were associated with a slower eGFR decline. Patients were categorized into 4 subgroups based on TA-P levels, with TA-P values < 1 g/d indicating better kidney outcomes. Conclusion: Proteinuria reduction was associated with improved kidney outcomes and slower eGFR decline in both C3G and IC-MPGN. |
| format | Article |
| id | doaj-art-cf9583b63f204936b573e6cd5b50bb26 |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-cf9583b63f204936b573e6cd5b50bb262025-08-20T03:47:10ZengElsevierKidney International Reports2468-02492025-04-011041223123610.1016/j.ekir.2025.01.024Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 GlomerulopathyFernando Caravaca-Fontán0Remedios Toledo-Rojas1Ana Huerta2José Luis Pérez-Canga3Patricia Martínez-Miguel4Rosa Miquel5Iara Da Silva6Úrsula Verdalles7Macarena Albornoz8Carmen Mercedes Durán López9Carmen Mon10Gema Fernández-Juárez11Manuel Praga12Teresa CaveroLuis F. QuintanaHelena MarcoXoana BarrosNatalia RamosNuria Rodríguez MendiolaSonia CruzAdela RodríguezCristina RabascoRaquel RodadoLoreto FernándezVanessa Pérez-GómezAna ÁvilaLuis BravoNatalia EspinosaNatalia AllendeMaria Dolores Sanchez de la NietaEva RodríguezMarta MelgosaAna HuertaRosa MiquelCarmen MonGloria FragaAlberto de LorenzoJuliana DraibeFayna GonzálezAmir ShabakaMaria Esperanza López-RubioMaría Ángeles FenollosaLuis Martín-PenagosSantiago Rodríguez de CórdobaElena Goicoechea de JorgeDepartment of Nephrology, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain; Correspondence: Fernando Caravaca-Fontán, Department of Nephrology, Research Institute Hospital 12 de Octubre (imas12), Avenida de Córdoba sn; 28041 Madrid, Spain.Department of Nephrology, Hospital Regional Universitario de Málaga, Málaga, SpainDepartment of Nephrology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, SpainDepartment of Nephrology, Hospital Universitario San Agustín, Avilés, Asturias, SpainDepartment of Nephrology, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, SpainDepartment of Nephrology, Hospital Universitario Canarias, Tenerife, SpainDepartment of Nephrology, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, SpainDepartment of Nephrology, Hospital Universitario Gregorio Marañón, Madrid, SpainDepartment of Nephrology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, SpainDepartment of Nephrology, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, SpainDepartment of Nephrology, Hospital Universitario Severo Ochoa, Leganés, Madrid, SpainDepartment of Nephrology, Hospital Universitario La Paz, Madrid, SpainDepartment of Medicine, Complutense University, Madrid, SpainIntroduction: C3 glomerulopathy (C3G) and primary immune complex–mediated membranoproliferative glomerulonephritis (IC-MPGN) are rare diseases that share a similar pathogenesis; however, the prognostic significance of proteinuria reduction remains poorly characterized. This study compared the outcomes in C3G and IC-MPGN and assessed the impact of changes in proteinuria on kidney prognosis. Methods: This retrospective, longitudinal, multicenter study used joint linear mixed-effects models to assess proteinuria trajectories, and Cox regression to evaluate their association with kidney failure. In addition, time-averaged proteinuria (TA-P) was calculated to determine its impact on kidney prognosis. Results: The study included 149 patients: 98 with C3G (66%) and 51 with IC-MPGN (34%) with a median age of 35 (interquartile range [IQR]: 22–53) years. During a median follow-up of 65 (IQR: 32–114) months, 44 patients (30%) progressed to kidney failure without differences across C3G or IC-MPGN. A strong association was observed between longitudinal increase in proteinuria and the risk of kidney failure. In addition, a ≥ 50% proteinuria reduction over time was associated with a lower risk of kidney failure (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.46–0.75, P < 0.001). Results were consistent in both C3G and IC-MPGN, and in those with baseline estimated glomerular filtration rate (eGFR) ≥ 30 ml/min per 1.73 m2 and proteinuria ≥ 1 g/d. A ≥30% proteinuria reduction at 6 months or a ≥50% proteinuria reduction at 12 months were associated with a slower eGFR decline. Patients were categorized into 4 subgroups based on TA-P levels, with TA-P values < 1 g/d indicating better kidney outcomes. Conclusion: Proteinuria reduction was associated with improved kidney outcomes and slower eGFR decline in both C3G and IC-MPGN.http://www.sciencedirect.com/science/article/pii/S246802492500049XC3 glomerulopathyglomerular filtration ratekidney failuremembranoproliferative glomerulonephritisproteinuria |
| spellingShingle | Fernando Caravaca-Fontán Remedios Toledo-Rojas Ana Huerta José Luis Pérez-Canga Patricia Martínez-Miguel Rosa Miquel Iara Da Silva Úrsula Verdalles Macarena Albornoz Carmen Mercedes Durán López Carmen Mon Gema Fernández-Juárez Manuel Praga Teresa Cavero Luis F. Quintana Helena Marco Xoana Barros Natalia Ramos Nuria Rodríguez Mendiola Sonia Cruz Adela Rodríguez Cristina Rabasco Raquel Rodado Loreto Fernández Vanessa Pérez-Gómez Ana Ávila Luis Bravo Natalia Espinosa Natalia Allende Maria Dolores Sanchez de la Nieta Eva Rodríguez Marta Melgosa Ana Huerta Rosa Miquel Carmen Mon Gloria Fraga Alberto de Lorenzo Juliana Draibe Fayna González Amir Shabaka Maria Esperanza López-Rubio María Ángeles Fenollosa Luis Martín-Penagos Santiago Rodríguez de Córdoba Elena Goicoechea de Jorge Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 Glomerulopathy Kidney International Reports C3 glomerulopathy glomerular filtration rate kidney failure membranoproliferative glomerulonephritis proteinuria |
| title | Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 Glomerulopathy |
| title_full | Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 Glomerulopathy |
| title_fullStr | Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 Glomerulopathy |
| title_full_unstemmed | Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 Glomerulopathy |
| title_short | Comparative Analysis of Proteinuria and Longitudinal Outcomes in Immune Complex Membranoproliferative Glomerulonephritis and C3 Glomerulopathy |
| title_sort | comparative analysis of proteinuria and longitudinal outcomes in immune complex membranoproliferative glomerulonephritis and c3 glomerulopathy |
| topic | C3 glomerulopathy glomerular filtration rate kidney failure membranoproliferative glomerulonephritis proteinuria |
| url | http://www.sciencedirect.com/science/article/pii/S246802492500049X |
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