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| Effect of Complement C4 Level on Treatment of Idiopathic Membranous Nephropathy |
| YANG Ni, YANG Xin-bo, GAO Xin, et al |
| Department of Nephrology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi 712000 |
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Abstract 【Objective】 To investigate the curative effect and predictive value of baseline complement C4 level in the treatment of idiopathic membranous nephropathy (IMN). 【Methods】 A total of 132 patients with IMN who were admitted to our hospital were treated with cyclophosphamide + glucocorticoids. Their clinical and biochemical data were collected at admission. The patients were followed up. According to the treatment effect, patients were divided into the remission group and the non-remission group. The predictive value of baseline complement C4 level on remission rate was analyzed, and the influencing factors of disease remission were analyzed as well. 【Results】 The median follow-up time was 25 months and the average follow-up time was (24.1±3.9) months. A total of 102 patients (77.3%) achieved disease remission and 30 patients did not. ROC curve analysis showed that the baseline complement C4 level predicting area under the curve of IMN disease remission was 0.76 (P=0.005), the sensitivity was 65.2%, and the specificity was 79.8%. Disease remission was associated with C3, C4, urine protein, albumin and pathological stage (P<0.05). Logistic analysis showed that C4, albumin and pathological staging were independent influencing factors of disease remission in IMN patients (P<0.05). On admission, patients with higher C4 level, lower albumin and stageⅢ-Ⅳ IMN had lower disease remission rate after treatment. 【Conclusion】 Baseline complement C4 level has predictive value for IMN treatment effect. IMN patients with elevated C4 on admission have a lower rate of disease remission after treatment and should be given clinical attention.
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Received: 10 October 2020
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2021, Vol. 38 
