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Int J Clin Exp Pathol 2013;6(5):904-910

Original Article
Glomerular and tubular C4d depositions in IgA nephropathy: relations with
histopathology and with albuminuria

Young-In Maeng, Min-Kyung Kim, Jae-Bok Park, Chang-Ho Cho, Hoon-Kyu Oh, Woo Jung Sung, Kwan-Kyu Park

Department of Pathology, School of Medicine, Catholic University of Daegu, Daegu, Korea

Received February 27, 2013; Accepted March 29, 2013; Epub April 15, 2013; Published May 1, 2013

Abstract: Background: C4d has been used as an evaluation marker for antibody-mediated rejection for solid organ transplantation. Although
some studies have proposed that complement activation is involved in renal diseases, very little information is available on pathogenesis. This
study was conducted to investigate C4d deposition in IgA nephropathy and to find its relations with histopathology and albuminuria. Methods:
This retrospective study included 23 patients who underwent renal biopsy at our medical center. The WHO grade of IgA nephropathy, interstitial
inflammation and fibrosis, C4d staining and medical records including sex, age, and urine albumin were reviewed. Results: Thirteen patients
(56.5%) were positive for C4d staining in the glomerulus and eleven patients (47.8%) were positive in the tubular epithelium. Glomerular C4d
deposition was associated with albuminuria (p=0.044), and tubular C4d deposition was associated with a higher grade of IgA nephropathy
(p=0.014). Conclusions: Activation of the complement system was involved in renal damage and was identified through deposition of C4d in
the glomerulus and tubules. Positive C4d staining in the glomerulus and the tubules may be associated with functional damage related to
glomerular filtration and poor renal outcome. (IJCEP1302041).

Keywords: Albuminuria, C4d, grade, IgA, nephropathy

Address correspondence to: Dr. Kwan-Kyu Park, Department of Pathology, School of Medicine, Catholic University of Daegu, 3056-6
Daemyung-4 Dong, Nam-gu, Daegu, 705-718, Republic of Korea. Phone: 053-650-4149; Fax: 053-650-3050; E-mail: kkpark@cu.ac.kr