C4d as a prognostic factor in a cohort of children with IgA nephropathy in a hospital in Cali, Colombia
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Berger disease
C4d complement
chronic kidney inssuficiency

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Forero Delgadillo JM, Duque Nieto N, Padilla Guzmán A, Torres Canchala L, Ochoa V, Jiménez C, Arrunategui AM, Huérfano N, Restrepo JM. C4d as a prognostic factor in a cohort of children with IgA nephropathy in a hospital in Cali, Colombia. Rev. Colomb. Nefrol. [Internet]. 2023 Feb. 24 [cited 2023 Apr. 1];10(2). Available from: https://revistanefrologia.org/index.php/rcn/article/view/624


Background: IgA nephropathy (IgAN) is the most common glomerular disease in the world. In pediatrics, the frequency of this disease is not well established, and it can lead to end-stage renal failure at 20 years in between 20-30% of cases. A relationship among positive histological C4d staining, and clinical and histological variables of worse renal prognosis has been described.

Purpose: The aim of the present study is to correlate the diagnostic presence of C4d in renal biopsies with clinical and histological variables in patients with IgAN.

Methods: Observational and retrospective study. Between 2011 and 2018, all pediatric patients with a histopathological diagnosis of IgAN, who had adequate renal biopsy material for C4d staining, were included. The main outcome variable was the glomerular filtration rate (GFR) at the time of diagnosis and at the last follow-up.

Results: Fourteen patients were included in the study. Two (14.2%) had positive staining for C4d in the diagnostic biopsy, of which none presented impaired renal function by GFR or moderate-severe proteinuria during the study. No relationship was found between positive C4d staining and histopathological variables of worse prognosis (including mesangial hypercellularity and interstitial fibrosis-tubular atrophy), according to the Oxford classification.

Conclusion: Given the small sample size, our findings were not consistent with the literature regarding the relationship between positive staining for C4d and clinical and histopathological variables of worse renal prognosis.

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