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논문분류	춘계학술대회 초록집
제목	Prognostic Implications of Dynamic Change in Glomerular C3 Deposition in Membranous Nephropathy
저자	WON HEE CHO
출판정보	2025; 2025(1):
키워드	Membranous nephropathy, Glomerular C3 deposition, Complement activation, Methylprednisolone pulse therapy
초록	Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults, with complement activation playing a key role its pathophysiology. However, the prognostic significance of glomerular C3 deposition, particularly in follow-up biopsies, remains unclear. This study evaluates the impact of changes in C3 deposition on clinical outcomes in MN patients following intravenous methylprednisolone (MPD) therapy. This retrospective study analyzed 11 patients with pathologically diagnosed MN who achieved remission after intravenous MPD pulse therapy and underwent follow-up kidney biopsies. Patients were stratified based on the presence or absence of glomerular C3 deposition in the follow-up biopsy. Clinical, laboratory, and histopathological data were analyzed to assess treatment response and long-term outcomes. Eight patients showed resolution of C3 deposition, while three exhibited persistent C3 deposition. Both groups experienced significant proteinuria reduction. However, patients with persistent-C3 deposition had higher recurrence rates and minimal histological improvement, whereas those with resolved C3 deposition maintained remission. Over a mean follow-up of 5.3 years, all patients in the no-C3 deposition group remained relapse-free, whereas all patients in the persistent-C3 deposition group experienced relapse. MPD pulse therapy remains a promising therapeutic modality for MN cases resistant to conventional oral steroid therapy. Although larger studies are necessary, the disappearance of glomerular C3 deposition may serve as a prognostic marker for treatment response, rather than proteinuria resolution, in MN.
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