Serum Complement C4 Levels Are a Useful Biomarker for Predicting End-Stage Renal Disease in Microscopic Polyangiitis

This study aimed to evaluate the risk factors for end-stage renal disease (ESRD) in microscopic polyangiitis (MPA). In total, 74 patients with MPA were enrolled, and we compared the baseline clinical characteristics and disease activity between MPA patients who have progressed to ESRD and those with...

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Published in:International journal of molecular sciences 2023-10, Vol.24 (19), p.14436
Main Authors: Matsuda, Shogo, Oe, Katsumasa, Kotani, Takuya, Okazaki, Ayana, Kiboshi, Takao, Suzuka, Takayasu, Wada, Yumiko, Shiba, Hideyuki, Hata, Kenichiro, Shoda, Takeshi, Takeuchi, Tohru
Format: Article
Language:English
Subjects:
Biomarkers
Creatinine
Drug dosages
Induction therapy
Kidney diseases
Medical prognosis
Multivariate analysis
Pathogenesis
Patients
Remission (Medicine)
Risk factors
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Summary:This study aimed to evaluate the risk factors for end-stage renal disease (ESRD) in microscopic polyangiitis (MPA). In total, 74 patients with MPA were enrolled, and we compared the baseline clinical characteristics and disease activity between MPA patients who have progressed to ESRD and those without ESRD to select predictive factors for ESRD. Out of 74 patients, 12 patients (16.2%) had ESRD during follow-up. Serum C4 levels were significantly higher in MPA patients who have progressed to ESRD than in those without ESRD (p = 0.009). Multivariate analyses revealed that high serum creatinine levels (odds ratio (OR) 4.4, 95% confidence interval (CI) 1.25–15.5) and high serum C4 levels (OR 1.24, 95% CI 1.03–1.49) were risk factors for ESRD. Using receiver operating characteristic analysis, the cut-off value for initial serum C4 levels and serum creatinine levels were 29.6 mg/dL and 3.54 mg/dL, respectively. Patients with MPA with a greater number of risk factors (serum C4 levels > 29.6 mg/dL and serum creatinine levels > 3.54 mg/dL) had a higher ESRD progression rate. Serum C4 levels were significantly positively correlated with serum creatinine levels and kidney Birmingham vasculitis activity score (p = 0.02 and 0.04, respectively). These results suggest that serum C4 levels are useful tools for assessing renal disease activity and prognosis in MPA.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms241914436