PMID- 24577364
OWN - NLM
STAT- MEDLINE
DCOM- 20150116
LR  - 20140402
IS  - 1660-2110 (Electronic)
IS  - 1660-2110 (Linking)
VI  - 126
IP  - 1
DP  - 2014
TI  - Association of low serum complement C3 with reduced patient and renal survival in 
      antimyeloperoxidase-associated small-vessel vasculitis.
PG  - 67-74
LID - 10.1159/000357154 [doi]
AB  - OBJECTIVE: This study aimed to determine the value of hypocomplementemia in 
      predicting the renal and patient survival of patients with antineutrophil 
      cytoplasmatic antibody-associated vasculitis (AAV). METHODS: A retrospective 
      analysis of 30 consecutive patients who were diagnosed with AAV and followed at 
      our hospital from 1996 to 2011 was performed. Renal outcome was determined by the 
      Modification of Diet in Renal Disease equation. Disease outcome measures included 
      patient survival and accrual of chronic kidney disease (CKD) defined as an 
      estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) from the date of 
      diagnosis. Logistic regression analysis was used to identify predictors of 
      survival. RESULTS: At presentation, 6 (20%) patients had a low C3 level, which 
      was significantly associated with older age (p = 0.009), higher C-reactive 
      protein (p = 0.02), a lower eGFR (p = 0.03), and anti-MPO antibody positivity (p 
      = 0.03). A low C3 level at presentation was significantly associated with a 
      reduced eGFR at the last study visit (p = 0.015, OR = 11; 95% CI 1.27-95.15). 
      During a mean follow-up of 9.0 +/- 6.2 years, 8 (26.6%) patients had accrued CKD 
      that was significantly associated with low C3 levels at presentation (p = 0.002, 
      OR = 22; 95% CI 2.36-204.7). Mortality was significantly associated with low 
      serum C3 levels at presentation (p = 0.02). CONCLUSION: We found that a low serum 
      C3 level at the time of diagnosis was significantly associated with reduced renal 
      and patient survival in patients with anti-MPO AAV. Our results suggest a role 
      for complement activation in the pathogenesis of AAV.
CI  - (c) 2014 S. Karger AG, Basel.
FAU - Molad, Yair
AU  - Molad Y
AD  - Rheumatology Unit, Beilinson Hospital, Rabin Medical Center, Petach Tikva, 
      Israel.
FAU - Tovar, Ana
AU  - Tovar A
FAU - Ofer-Shiber, Shachaf
AU  - Ofer-Shiber S
LA  - eng
PT  - Journal Article
DEP - 20140227
PL  - Switzerland
TA  - Nephron Clin Pract
JT  - Nephron. Clinical practice
JID - 101159763
RN  - 0 (Antibodies)
RN  - 0 (Complement C3)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - AYI8EX34EU (Creatinine)
RN  - EC 1.11.1.7 (Peroxidase)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/*blood/complications/drug therapy
MH  - Antibodies/blood
MH  - C-Reactive Protein/metabolism
MH  - Complement C3/*deficiency/metabolism
MH  - Creatinine/blood
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Glomerular Filtration Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peroxidase/immunology
MH  - Renal Insufficiency, Chronic/complications/pathology/*physiopathology
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Young Adult
EDAT- 2014/03/01 06:00
MHDA- 2015/01/17 06:00
CRDT- 2014/03/01 06:00
PHST- 2013/01/04 00:00 [received]
PHST- 2013/10/29 00:00 [accepted]
PHST- 2014/03/01 06:00 [entrez]
PHST- 2014/03/01 06:00 [pubmed]
PHST- 2015/01/17 06:00 [medline]
AID - 000357154 [pii]
AID - 10.1159/000357154 [doi]
PST - ppublish
SO  - Nephron Clin Pract. 2014;126(1):67-74. doi: 10.1159/000357154. Epub 2014 Feb 27.