SummaryBackground and objectives The term C3 glomerulopathy describes renal disorders characterized by the presence of glomerular deposits composed of C3 in the absence of significant amounts of Ig. On the basis of electron microscopy appearance, subsets of C3 glomerulopathy include dense deposit disease (DDD) and C3 glomerulonephritis (C3GN). The full spectrum of histologic change observed in C3 glomerulopathy has yet to be defined and pathologic predictors of renal outcome within this patient population remain largely unknown. This study thus characterized a large C3 glomerulopathy cohort and identified clinicopathologic predictors of renal outcome.Design, setting, participants, & measurements All patients with kidney biopsies fulfilling criteria for C3 glomerulopathy from two quaternary renal centers within the United Kingdom and Ireland between 1992 and 2012 were retrospectively reviewed. We recorded histologic, demographic, and clinical data and determined predictors of ESRD using the Cox proportional hazards model.Results Eighty patients with C3 glomerulopathy were identified: 21 with DDD and 59 with C3GN. Patients with DDD were younger, more likely to have low serum C3 levels, and more likely to have crescentic GN than patients with C3GN. Patients with C3GN were older and had more severe arteriolar sclerosis, glomerular sclerosis, and interstitial scarring than patients with DDD. Of 70 patients with available follow-up data, 20 (29%) progressed to ESRD after a median of 28 months. Age .16 years, DDD subtype, and crescentic GN were independent predictors of ESRD within the entire cohort. Renal impairment at presentation predicted ESRD only among patients with DDD.Conclusions Although detailed serologic and genetic data are lacking, this study nevertheless identifies important clinicopathologic distinctions between patients with DDD and C3GN. These include independent predictors of renal outcome. If replicated in other cohorts, these predictors could be used to stratify patients, enabling application of emerging mechanism-based therapies to patients at high risk for poor renal outcome.

We report "exact" ab initio calculations of potential energies for the interaction of two helium atoms. The quantum Monte Carlo method used is exact in that it requires no mathematical or physical approximations beyond those of the Schriidinger equation. As in most Monte Carlo methods there is a statistical or sampling error which is readily estimated. For the equilibrium internuclear distance of 5.6 bohr, the calculated electronic energy is-5.807 483 6 f 0.000 000 3 hartrees and the corresponding well depth (e/k) is 11.01 f 0.10 K. The calculated total energies are approximately 0.004 hartrees or 1200 K below the most recent variational calculations of Liu and McLean [J. Chem. Phys. 92, 2348 (1989)]. The calculated interaction energies are in excellent agreement with the interaction energies of Liu and McLean and with a recent experimental/theoretical compromise potential energy curve of Aziz and Slaman [J. Chem. Phys. 94, 8047 (199 1)] which successfully predicts a variety of experimental measurements. The error bars of the "exact" quantum Monte Carlo interaction energies straddle the Liu-McLean and Aziz-Slaman results. The Monte Carlo results support the existence of a bound dimer state.

There have been few studies of patients with renal allografts functioning for more than 20 years. We sought to identify clinical factors associated with ultra longterm (>20 year) renal allograft survival and to describe the clinical features of these patients. Comorbidities included skin cancer (36.1%), coronary heart disease (17.3%) and other malignancies (14.5%). This study identifies factors associated with long-term allograft survival and a high rate of morbidity and early mortality in long-term transplant recipients.

Using a genome-wide approach, we have identified two associations with five-yr creatinine levels in renal transplant recipients treated with calcineurin inhibitors. Independent replication is now warranted to clarify the clinical significance of these results.

We report an improved Monte Carlo method for quantum chemistry which permits the exact treatment of many-electron systems. The method combines many of the best features of earlier fixed-node, released-node, and positive/negative cancellation methods with new ideas for relocation after node crossing, self-cancellations, multiple cancellations, maximum use of symmetry in promoting cancellations, and rigorous evaluation of energies using importance sampling with trial wave functions. The method is illustrated with applications to the problems of the first excited state of a particle in a two-dimensional box, the two-electron system of excited H, "I,+ , and the three-electron system of linear symmetric HHH, the intermediate for the reaction H + H,-+H2 + H.