Treatment of C3 Glomerulopathy in Adults Aged 18 or Older (Native or Transplant Kidney)
This protocol covers adults aged 18 years or older with C3 glomerulopathy (C3G) — a form of membranoproliferative glomerulonephritis — affecting either the native kidney or a post-transplant kidney. Both settings share core management priorities around proteinuria, blood pressure, and edema.
Clinical Scenario
Adults (18 years or older) with C3 glomerulopathy, whether in a native or transplanted kidney. Key clinical concerns in this population include proteinuria, hypertension, and edema, all of which inform the treatment strategy.
Treatment Approach — Partial Overview
Management begins with general supportive care for glomerular disease, centred on controlling proteinuria and blood pressure — including renin-angiotensin-aldosterone system (RAAS) inhibition and related interventions. The complete structured regimen includes further steps not detailed here.
References
DOI: 10.1016/j.ekir.2025.10.020
- General supportive care for all patients with glomerular diseases who have edema, proteinuria and/or hypertension
- RAASi (e.g. ACEi or ARBs) and potentially other antiproteinuric agents
- Treatments have focused on nonspecific approaches of key importance in many kidney diseases such as optimization of blood pressure and proteinuria control.
- In 2025, iptacopan was also approved by the US Food and Drug Administration for the treatment of adults with C3G to reduce proteinuria, and by the European Medicines Agency for the treatment of adults with C3G in combination with a renin-angiotensin-aldosterone system inhibitor or as monotherapy in patients who are renin-angiotensin-aldosterone system inhibitor-intolerant.
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