ASSOCIATION BETWEEN SERUM COMPLEMENT3 LEVELS AND RENAL ARTERIOSCLEROSIS IN PATIENTS WITH CHRONIC KIDNEY DISEASE

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https://storage.unitedwebnetwork.com/files/1099/028021474d89f04d610eee22a67e6f55.pdf

Abstract Title *

ASSOCIATION BETWEEN SERUM COMPLEMENT3 LEVELS AND RENAL ARTERIOSCLEROSIS IN PATIENTS WITH CHRONIC KIDNEY DISEASE

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Co-author 1

yuki shinzato shinzato.priv@gmail.com university of the ryukyus hospital Department of Cardiovascular Medicine, Nephrology and Neurology ginowan okinawa Japan *

Co-author 2

kentaro kohagura kohagura@cs.u-ryukyu.ac.jp university of the ryukyus hospital Dialysis Unit ginowan okinawa Japan -

Co-author 3

nanako oshiro nananew@ymail.ne.jp university of the ryukyus hospital Dialysis Unit ginowan okinawa Japan -

Co-author 4

ryo zamami janeways_tree@yahoo.co.jp university of the ryukyus hospital Department of Cardiovascular Medicine, Nephrology and Neurology ginowan okinawa Japan -

Co-author 5

kenya kusunose echo.cardio@gmail.com university of the ryukyus hospital Department of Cardiovascular Medicine, Nephrology and Neurology ginowan okinawa Japan -

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Introduction

Complement 3 (C3), also recognized as an adipocytokine, has been implicated in the development of hyaline changes within renal arterioles. While aging and hypertension are well-known contributors to renal arteriosclerosis in patients with chronic kidney disease (CKD), the association between serum C3 levels and renal arteriosclerosis remains unclear. This study aimed to evaluate the relationship between serum C3 concentrations and intimal thickening of renal small arteries in patients with CKD.

Methods

We retrospectively analyzed 135 patients who underwent renal biopsy at our institution between 2010 and 2013 after excluding those with vasculitis, lupus nephritis, or other secondary glomerular diseases from an initial cohort of 174 patients. The severity of arteriolar sclerosis was semi-quantitatively assessed using the mean intimal thickening index of small arteries. Patients were divided into two groups according to the median serum C3 level. The association between high serum C3 levels and severe arterial intimal thickening (upper tertile of the index) was examined using multivariate logistic regression analysis adjusted for age, sex, blood pressure, estimated glomerular filtration rate (eGFR), proteinuria, and metabolic factors.

Results

The median values for age, blood pressure, eGFR, urinary protein, and serum C3 were 43.0 years, 124/75 mmHg, 68.6 mL/min/1.73 m², 0.81 g/gCr, and 105 mg/dL, respectively. Serum C3 levels showed positive correlations with body mass index, total cholesterol, triglycerides, low-density lipoprotein cholesterol, HbA1c, high-sensitivity C-reactive protein, and oxidative stress index. In multivariate logistic regression analysis, elevated serum C3 was independently associated with severe arterial intimal thickening (odds ratio 10.3, 95%CI 2.6–40.9, P < 0.05）, independent of age, sex, and other risk factors.

Conclusion

Serum C3 elevation, possibly reflecting its role as an adipocytokine, was independently associated with renal arteriosclerosis in patients with CKD. These findings suggest that C3 may contribute to vascular remodeling in the kidney beyond traditional risk factors. Further studies are warranted to clarify its impact on renal outcomes and disease progression.

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