This protocol addresses the management of membranoproliferative glomerulonephritis (MPGN) — specifically C3 glomerulopathy or primary immune complex MPGN — in children younger than 12 years. This age group represents a particularly underserved population: randomized controlled trials have consistently excluded patients under 12, leaving clinicians to rely on small cohort data and compassionate-use case reports. Disease onset in children often occurs before 12 years of age, making this an urgent unmet need.
Management in this population centers on general supportive care tailored to glomerular disease presenting with edema, proteinuria, and/or hypertension. This includes lifestyle measures alongside pharmacological agents targeting blood pressure and proteinuria — including renin-angiotensin-aldosterone system inhibitors.
DOI: 10.1016/j.ekir.2025.10.020
Finally, it is important to acknowledge that randomized controlled trials have excluded patients aged < 12 years and as such, the only experience of complement inhibitor therapy in this group comes from small cohorts or individual cases of compassionate use.
This represents an urgent unmet need as the disease onset in children often occurs before 12 years of age.
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.
Alternative anti-hypertensives (e.g. CCBs).
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