Fast Five Quiz: C3G Management

A. Brent Alper, Jr, MD, MPH


April 24, 2023

Currently, the therapeutic alternatives available to treat C3G are supportive therapy, immunosuppression, and anticomplement therapy. There are many potential new agents for targeted therapy currently under investigation. Results from the ACCOLADE trial show a change in a biopsy-based C3G histologic index activity score with daily oral treatment with avacopan as primary endpoint. Results from a secondary analysis, as reported by Bomback, show that avacopan was significantly linked with a rise in patients' disease chronicity score compared with placebo. This is notable because data show that C3 histologic disease activity score is a predictor of kidney failure and that total chronicity score is the principal histologic correlate of kidney failure.

Kidney transplantation is usually performed in patients who have reached end-stage renal disease (ESRD). Unfortunately, there is a high recurrence rate of C3G in patients who undergo renal allograft. Though this is a good treatment option, it is often not curative.

Although lowering sodium and protein intake may help alleviate some stress on the kidneys and helps with fluid retention and management of hypertension, dietary restrictions are not considered part of the treatment of C3G.

Pharmacologic therapy with antibiotics and loop diuretics can be used in the treatment of some forms of acute infection associated glomerulonephritis. Glucocorticoids are useful in severe cases of focal segmental glomerulosclerosis.

Learn more about ongoing treatment research for patients with C3G.


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