Evaluation of immunohistochemistry staining of C4d marker in IgA nephropathy patients and compared with the histological findings of prognosis

Abstract

Objective: We evaluate the immunohistochemical staining with the C4d marker in IgA Nephropathy patients and compare it with the histologic and clinical findings that affected prognosis. Therefore, we determine the predictive value of C4d in disease progression to ESRD. Materials and Methods: In this study, biopsy specimens of all IgAN patients referred to Imam Reza Hospital in Tabriz were collected for 4 years and after being eligible for the study. Their samples were evaluated by immunohistochemical staining with a C4d monoclonal antibody for strong and diffused mesangial staining of glomeruli and then studied for association with histological, clinical and laboratory factors. Results: In this study, the C4d positive was associated with mesangial hypercellularity (P-value = 0.001), segmental glomerulosclerosis (P-value = 0.003) and endocapillary hypercellularity (P-value = 0.001) for statistically aspect, but C4d was not associated with Tubular atrophy / Interstitial fibrosis (P-value = 0.08). The study also showed that C4d positively correlated with elevated blood pressure, increased proteinuria, hematuria, high creatinine and mean decrease in eGFR (P-value <0.05).