Atatürk Üniversitesi Atatürk Üniversitesi
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Makale Tam Makale Uluslararası 2026

Prognostic Implications of Serum C3 Levels in Primary Membranous Nephropathy: A Retrospective Cohort Analysis Implicaciones Pronósticas de los Niveles Séricos de C3 en la Nefropatía Membranosa Primaria: Un Análisis de Cohorte Retrospectivo

Engin Onan, AYŞE SERRA UÇAR, AYŞEGÜL ORUÇ, Müge Doksan, NECMİ EREN, Serhat Karadağ, Gülizar Şahin, Kenan Turgutalp, NURHAN SEYAHİ, Sim Kutlay, Şimal Köksal Cevher, Belda Dursun, Musa Pınar, Mehmet Deniz Ayli, Taner Baştürk, Garip Şahin Sedat Ustundag, Zülfükar Yılmaz, Serap Yadigar, Özkan Güngör, Erhan Tatar, Feyza Bora, Mürvet Yılmaz, Murat Hayri Sipahioğlu, Sena Ulu, Ramazan Öztürk, Meltem Gürsu, Bülent Kaya, Ömer Faruk Akçay, Yelda Deligöz Bildacı, Cuma Bülent Gül, Hakkı Arıkan, Şebnem Karakan, Dilek Torun, Hacı Hasan Yeter, Mansur Kayataş, Can Sevinç, Yavuz Ayar, Kültigin Türkmen, Saide Elif Güllülü Boz, Sevinç Püren Yücel Karakaya, Nazlı Totik Doğan, Gulsah Seydaoglu, Savaş Öztürk

REVISTA DE NEFROLOGIA DIALISIS Y TRASPLANTE Cilt 46 · Sayı 1 · ss. 12–25 · 01.01.2026

Özet

Background: The complement system plays a crucial role in the pathogenesis of membranous nephropathy (MN). Serum complement 3 (C3) levels may be a prognostic marker. This study investigates the prognostic significance of serum C3 levels in patients with primary MN. Methods: This study aims to evaluate the prognostic value of serum C3 levels in primary MN by analyzing their associations with demographic, clinical, and histopathological features, as well as treatment outcomes. We used data from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group, a nationwide registry. Results: A total of 1,259 biopsy-proven primary MN patients were included. Serum C3 levels were low in 45 (3.6%) patients. Patients with low serum C3 levels demonstrated higher baseline serum creatinine (1.3±1.1mg/dL vs. 0.9±0.8mg/ dL, p=0.006) and proteinuria (9714±6329 mg/24h vs. 7052±4463mg/24h, p=0.002), and lower albumin levels (2.3±0.8g/dL vs. 2.7±0.8g/ dL, p=0.007) compared to those with normal serum C3. At one-year follow-up, both groups showed significant decreases in proteinuria and increases in albumin levels. In repeated-measures analyses, creatinine and proteinuria showed significant differences over time between the C3 groups; albumin did not (p: 0.029, 0.013, and 0.705, respectively). The remission rates were not different between C3 groups, 10 cases (62.5%) in the Low group, and 432 cases (76.1%) in the Normal group, p: 0.237. Relapse rates were notably higher in patients with low serum C3 levels compared to those with normal serum C3 (62.5% vs. 38.0%, p=0.049). Multivariate analysis showed that age (HR: 1.017, 95% CI: 1.002–1.032, p=0.025) and serum albumin levels (HR: 0.759, 95% CI: 0.568–1.015, p=0.063) were significant predictors of remission, while serum C3 levels were not. Conclusion: Low serum C3 levels in primary MN are associated with worse baseline clinical and histopathological parameters and higher relapse rates, but are not independently predictive of remission. Serum C3 may be a useful prognostic marker for relapse risk.

Anahtar kelimeler

Türkiye prognosis Membranous Nephropathy Serum Complement 3 TSN-GOLD Working Group

Atıf için künye

Onan, E., UÇAR, A. S., ORUÇ, A., Doksan, M., EREN, N., Karadağ, S., Şahin, G., Turgutalp, K., SEYAHİ, N., Kutlay, S., Cevher, Ş. K., Dursun, B., Pınar, M., Ayli, M. D., Baştürk, T., Ustundag, G. Ş. S., Yılmaz, Z., Yadigar, S., Güngör, Ö., … Öztürk, S. (2026). Prognostic Implications of Serum C3 Levels in Primary Membranous Nephropathy: A Retrospective Cohort Analysis Implicaciones Pronósticas de los Niveles Séricos de C3 en la Nefropatía Membranosa Primaria: Un Análisis de Cohorte Retrospectivo. REVISTA DE NEFROLOGIA DIALISIS Y TRASPLANTE, 46(1), 12–25. https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=105035296830&origin=inward

BibTeX 
@article{onan2026-243664,
  author = {Onan, Engin and UÇAR, AYŞE SERRA and ORUÇ, AYŞEGÜL and Doksan, Müge and EREN, NECMİ and Karadağ, Serhat and Şahin, Gülizar and Turgutalp, Kenan and SEYAHİ, NURHAN and Kutlay, Sim and Cevher, Şimal Köksal and Dursun, Belda and Pınar, Musa and Ayli, Mehmet Deniz and Baştürk, Taner and Ustundag, Garip Şahin Sedat and Yılmaz, Zülfükar and Yadigar, Serap and Güngör, Özkan and Tatar, Erhan and Bora, Feyza and Yılmaz, Mürvet and Sipahioğlu, Murat Hayri and Ulu, Sena and Öztürk, Ramazan and Gürsu, Meltem and Kaya, Bülent and Akçay, Ömer Faruk and Bildacı, Yelda Deligöz and Gül, Cuma Bülent and Arıkan, Hakkı and Karakan, Şebnem and Torun, Dilek and Yeter, Hacı Hasan and Kayataş, Mansur and Sevinç, Can and Ayar, Yavuz and Türkmen, Kültigin and Boz, Saide Elif Güllülü and Karakaya, Sevinç Püren Yücel and Doğan, Nazlı Totik and Seydaoglu, Gulsah and Öztürk, Savaş},
  title = {Prognostic Implications of Serum C3 Levels in Primary Membranous Nephropathy: A Retrospective Cohort Analysis Implicaciones Pronósticas de los Niveles Séricos de C3 en la Nefropatía Membranosa Primaria: Un Análisis de Cohorte Retrospectivo},
  journal = {REVISTA DE NEFROLOGIA DIALISIS Y TRASPLANTE},
  year = {2026},
  volume = {46},
  number = {1},
  pages = {12--25},
  issn = {0326-3428},
  url = {https://akademik.atauni.edu.tr/yayinlar/243664-prognostic-implications-of-serum-c3-levels-in-primary-membranous-nephropathy-a}
}