Advancing Treatment for C3G; Targeting the Complement System for Personalized Kidney Care - Episode 3
The Cost of Diagnostic Delay of C3G Across Age Groups
Panelists discuss how C3 glomerulopathy (C3G) is triggered by factors like infections or pregnancy that activate the alternative pathway in genetically predisposed individuals, presenting with diverse clinical manifestations that often overlap with other glomerular diseases, making diagnosis challenging without kidney biopsy.
Video content above is prompted by the following:
Early Diagnosis and Treatment of C3G Patients
This summary addresses the importance of timely diagnosis and treatment for patients with C3G, based on a conversation between Sayna Norouzi, MD; Bradley Dixon, MD; and Andrew S. Bomback, MD, MPH.
Key Points:
- Natural Disease Progression: C3G is characterized by slow but relentless progression toward chronic kidney disease, with approximately 50% of patients developing end-stage kidney disease within 10 to 15 years after diagnosis, despite available treatments.
- Pathophysiology of Progression: The glomerular inflammation caused by C3G leads to destructive fibrotic reactions, resulting in glomerulosclerosis. This progresses to hyperfiltration of remaining nephrons, causing accelerated nephron loss and ultimately kidney failure.
- Treatment Challenges: Even when diagnosed promptly, historically available treatment tools have been limited in their effectiveness for C3G patients.
- Dense Deposit Disease vs C3 Glomerulonephritis: While European cohorts suggested dense deposit disease progresses faster than C3G, a New York cohort of over 100 patients showed both subtypes progressing at the same rate.
- Impact of Delayed Diagnosis: Many patients with C3 glomerulonephritis are diagnosed late when significant chronicity is already present on biopsies. This delay in diagnosis likely contributes to worse outcomes and faster progression to kidney failure.
These findings emphasize the critical importance of early diagnosis and intervention in C3G to potentially slow disease progression and improve long-term kidney outcomes.
