AUTHOR=Peng Yingchao , Li Banghai , Li Xiaojie , Ju Tao , Zhang Zhiqiang , Wang Peipei , Sun Tao , Shu Jiaping , Wang Meiqiu , Sun Xiaoyi , Chen Huangyu , Gao Chunlin , Xia Zhengkun TITLE=Glomerular capillary C3 deposition as a risk factor for unfavorable renal outcome in pediatric primary focal segmental glomerular sclerosis JOURNAL=Frontiers in Pediatrics VOLUME=11 YEAR=2023 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1137375 DOI=10.3389/fped.2023.1137375 ISSN=2296-2360 ABSTRACT=Introduction

Some patients with primary focal segmental sclerosis (FSGS) demonstrate complement 3 (C3) deposition in glomerular capillary loops (Cap-C3) and/or mesangial area (Mes-C3). The clinicopathological and prognostic significance of C3 deposition remains incompletely investigated, especially in the pediatric cohort.

Methods

We retrospectively analyzed 264 children of biopsy-proven primary FSGS between January 2003 and December 2020. The correlation between Cap-C3 and renal outcome was evaluated by the Kaplan-Meier method and Cox multivariate regression analysis. Renal end-point event was defined as the development of end-stage renal disease, death for renal disease, or an estimated glomerular filtration rate reduction by at least 50% from baseline.

Results

Among the 264 patients, 30 (11.4%) had Cap-C3. Kaplan-Meier analysis showed that patients with Cap-C3 had significantly lower renal survival rates than patients without Cap-C3 (60.17% vs. 84.71% at 5 years, 39.49% vs. 65.55% at 10 years, P < 0.01). Cox multivariate regression analysis showed that Cap-C3 was an independent risk factor for poor renal outcome (HR 3.53, 95% CI 1.22–10.19, P = 0.02).

Conclusion

Glomerular capillary C3 deposition was an independent risk factor for unfavorable renal outcome in children with primary FSGS.