Introduction: IgAN occurs following abnormal IgA deposition in the glomerular mesangial regions. It is the most common primary glomerular disease and one of the causes of CKD-KRT, so it is necessary to identify clinical and histopathological findings that predict progression to CKD-KRT. In the physiopathology of this disease, C4d causes serious renal injuries and should be counted as a significant prognostic factor too. This study examined C4d biomarker and compare it with findings affecting prognosis, to determine the predictive value of the C4d in progression to CKD-KRT in IgAN.

Materials and methods: In this study, all biopsy samples of IgAN patients who referred to Imam Reza Hospital in Tabriz were collected retrospectively from March 2015 to September 2019. Their samples were evaluated C4d immunohistochemical staining and positive samples have compared with Clinical-histopathological findings affecting prognosis. Statistical data were analyzed using Spearman and Chi-square correlation tests and mean and standard deviation.

Results:In this study, After analyzing clinical and histological findings of 45 patients with nephropathy, it was observed that C4d positivity has a significant association with mesangial hypercellularity (p=0.001), segmental glomerulosclerosis (p=0.003), and endocapillary hypercellularity (p=0.001); however, it did not show a significant relationship with tubular atrophy / interstitial fibrosis (p=0.08). The study also found that C4d positivity was significantly (p

Conclusion: This study showed that immunohistochemical staining of C4d is a useful method for evaluating the prognosis of the severity of renal injuries in patients with IgAN and could be a valuable alternative for most Clinical-histopathological factors routinely used as predictive factors for its progression to CKD-KRT, especially when the biopsy specimen size is small and insufficient for other studies.

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This work is licensed under a Creative Commons Attribution 4.0 License.