Analysis Of Clinical-Pathological Features In 41 Cases Of IgA Nephropathy With C1q Deposition

Objective: To study the clinical-pathological features of primary IgA nephropathy(IgAN)with glomerular C1 q deposition,and explore whether the deposition of C1 q can be used as a marker to judge the severity of IgAN.Methods: IgAN patients diagnosed with biopsy by the Department of Nephrology,Peking University Shenzhen Hospital from October 2011 to December 2018 were recruited.Excluding patients who are younger than 18 years old,and with less than 7 glomeruli under microscope.Excluding secondary IgAN such as lupus nephritis,anaphy lactoid purpura nephritis,and other nephrosis like hypertensive nephropathy.We divided these patients into C1 q positive patients(41 cases)and C1 q negative patients(136 cases),and collected their clinical data including gender,age,and hypertension,serum creatinine,24-hour urine protein and e GFR.All patients were followed up.The data were analyzed by SPSS 24.0 software according to statistical methods.Results: 1.5.6% IgAN patients in our hospital had C1 q deposition.2.There were no significant differences in the gender,age,and the level of hypertension between two groups(P>0.05).3.Serum creatinine and 24-hour urine protein levels were higher in the C1 q positive patients(P < 0.05).The level of e GFR in C1 q positive patients were lower(P<0.05).4.C1 q positive patients had higher proportion of mesangial proliferation(M1),tubular atrophy or interstitial fibrosis(T1~2)according to the Oxford pathologic classification criteria compared with C1 q negative patients(P<0.05).There were no significant differences in the incidence of glomerular endothelial cell hyperplasia(E1),segmental glomerulosclerosis(S1)and crescent formation(C1~2)(P>0.05).5.The differences in Haas classification between two groups was statistically significant.The Haas classification of patients with C1 q deposition is higher.6.The renal cumulative survival rate was lower in C1 q positive patients.C1 q deposition was an independent risk factor for poor renal outcome.Conclusion: Patients with C1 q deposition had heavier clinical and pathological lesions,and had poorer prognosis.