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Serum complement factor B is associated with disease activity and progression of idiopathic membranous nephropathy concomitant with IgA nephropathy

  • Nephrology - Original Paper
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Abstract

Purpose

Few studies have reported the roles of the complement system in concomitant idiopathic membranous nephropathy and IgA nephropathy (IMN-IgAN). Complement factor B (CFB) is a crucial factor that involved in the alternative complement pathway. We aimed to evaluate the association between disease activity (eGFR, anti-PLA2R antibody levels and 24 h urinary protein excretion), progression and serum CFB levels of IMN-IgAN patients.

Methods

In total, 39 IMN-IgAN patients (median follow-up, 46.6 months), 99 IMN patients and 92 IgAN patients participated in this study. The disease progression event was defined as end-stage renal disease (ESRD) or a 30% decline in estimated glomerular filtration rate (eGFR). The serum CFB concentration was measured by enzyme-linked immunosorbent assay.

Results

Serum CFB levels were lower in IMN-IgAN patients than in patients with IgAN only (P < .001). Serum CFB levels correlated positively with serum creatinine levels, anti-PLA2R antibody levels and 24 h urinary protein excretion (P < .05). Kaplan–Meier analysis revealed that IMN-IgAN patients with high serum CFB levels had a significantly lower cumulative renal survival rate than patients with low levels (log-rank test, P = .009). Multivariate Cox regression analysis showed that high baseline serum CFB levels were significantly associated with poor renal outcome in patients with IMN-IgAN (HR: 2.727, 95% CI 1.076–6.913, P = .034).

Conclusion

High serum CFB levels correlated with increased serum creatinine, anti-PLA2R antibody and urinary protein excretion as well as poor renal prognosis in patients with IMN-IgAN, indicating that serum CFB may be a marker of disease activity and progression.

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Availability of data and material

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No. U1904208).

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Authors and Affiliations

  1. Pediatric Urodynamic Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China

    Feng Ping Ji, Yan Ping Zhang, Er Peng Liu & Jian Guo Wen

  2. Department of Nephrology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China

    Lu Wen

  3. Department of Urology, First Affiliated Hospital of Zhengzhou University, Jianshe East Road No.1, Zhengzhou, 450052, China

    Feng Ping Ji, Yan Ping Zhang, Er Peng Liu & Jian Guo Wen

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  1. Feng Ping Ji
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  2. Lu Wen
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  3. Yan Ping Zhang
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  4. Er Peng Liu
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  5. Jian Guo Wen
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Contributions

JFP conceived and designed articles, collected data, measured indicators, analysed the data, wrote the paper, prepared figures, reviewed draft of the paper, and revised the paper. WL collected data, measured indicators, analysed the data, reviewed draft of the paper and revised the paper. ZYP and LEP collected data, analysed data, and reviewed draft papers. WJG conceived and designed articles, got the financial supports from the Foundations, provided the experimental platform and equipment, and reviewed drafts of the paper. All authors have read and approved the final manuscript.

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Correspondence to Jian Guo Wen.

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The authors declare that they have no competing interests.

Ethical approval

The study was approved by the ethics committee of First Affiliated Hospital of Zhengzhou University, China (2019-KY-164), and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants prior to their inclusion in this study.

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Ji, F.P., Wen, L., Zhang, Y.P. et al. Serum complement factor B is associated with disease activity and progression of idiopathic membranous nephropathy concomitant with IgA nephropathy. Int Urol Nephrol 54, 1287–1294 (2022). https://doi.org/10.1007/s11255-021-02997-2

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  • DOI: https://doi.org/10.1007/s11255-021-02997-2

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