Effectiveness of mycophenolate mofetil in C3 glomerulonephritis

C3 glomerulonephritis is a clinicopathologic entity defined by the presence of isolated or dominant deposits of C3 on immunofluorescence. To explore the effect of immunosuppression on C3 glomerulonephritis, we studied a series of 60 patients in whom a complete registry of treatments was available ov...

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Published in:Kidney international 2015-11, Vol.88 (5), p.1153-1160
Main Authors: Rabasco, Cristina, Cavero, Teresa, Román, Elena, Rojas-Rivera, Jorge, Olea, Teresa, Espinosa, Mario, Cabello, Virginia, Fernández-Juarez, Gema, González, Fayna, Ávila, Ana, Baltar, José María, Díaz, Montserrat, Alegre, Raquel, Elías, Sandra, Antón, Monserrat, Frutos, Miguel Angel, Pobes, Alfonso, Blasco, Miguel, Martín, Francisco, Bernis, Carmen, Macías, Manuel, Barroso, Sergio, de Lorenzo, Alberto, Ariceta, Gema, López-Mendoza, Manuel, Rivas, Begoña, López-Revuelta, Katia, Campistol, José María, Mendizábal, Santiago, de Córdoba, Santiago Rodríguez, Praga, Manuel
Format: Article
Language:English
Subjects:
Adolescent
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Anti-Inflammatory Agents - therapeutic use
complement
Complement C3
Creatinine - blood
Cyclophosphamide - therapeutic use
Disease Progression
Drug Therapy, Combination
Female
Follow-Up Studies
glomerulonephritis
Glomerulonephritis - complications
Glomerulonephritis - drug therapy
Glomerulonephritis - immunology
Humans
Immunosuppressive Agents - therapeutic use
Kidney Failure, Chronic - etiology
Male
membranoproliferative glomerulonephritis (MPGN)
Middle Aged
Mycophenolic Acid - analogs & derivatives
Mycophenolic Acid - therapeutic use
Retrospective Studies
Survival Rate
Young Adult
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Summary:C3 glomerulonephritis is a clinicopathologic entity defined by the presence of isolated or dominant deposits of C3 on immunofluorescence. To explore the effect of immunosuppression on C3 glomerulonephritis, we studied a series of 60 patients in whom a complete registry of treatments was available over a median follow-up of 47months. Twenty patients had not received immunosuppressive treatments. In the remaining 40 patients, 22 had been treated with corticosteroids plus mycophenolate mofetil while 18 were treated with other immunosuppressive regimens (corticosteroids alone or corticosteroids plus cyclophosphamide). The number of patients developing endstage renal disease was significantly lower among treated compared with untreated patients (3 vs. 7 patients, respectively). No patient in the corticosteroids plus mycophenolate mofetil group doubled serum creatinine nor developed end-stage renal disease, as compared with 7 (significant) and 3 (not significant), respectively, in patients treated with other immunosuppressive regimens. Renal survival (100, 80, and 72% at 5years) and the number of patients achieving clinical remission (86, 50, and 25%) were significantly higher in patients treated with corticosteroids plus mycophenolate mofetil as compared with patients treated with other immunosuppressive regimens and untreated patients, respectively. Thus, immunosuppressive treatments, particularly corticosteroids plus mycophenolate mofetil, can be beneficial in C3 glomerulonephritis.
ISSN:0085-2538
1523-1755
DOI:10.1038/ki.2015.227