Complement-Mediated Kidney Diseases Toolkit

Complement-mediated kidney diseases (CMKDs), although less well-known and considered rare, are an important and complex area of kidney health that needs to be better recognized so that optimal care may be provided.

There are over 40 activating and inhibiting proteins in three separate pathways of complement system that finally converge into a common terminal pathway. The kidney is particularly susceptible to damage by complement. Activation of the complement system is tightly regulated by a series of soluble and membrane bound proteins. Failure of these checking mechanisms is one of the major causes and/or drivers of CMKDs.

Raising awareness of these diseases and developing educational and implementation tools supports clinicians in building their understanding of CMKDs, and in their clinical practice.

Discover the toolkit below, and stay tuned as more tools and resources are added periodically.

Overview of the Complement System and CMKDs

This infographic, accompanied by narrative description, provides an overview of the complement system and related kidney diseases.

Infographics and How-To Guides

Content will continue to be added throughout the year. Make sure to check back!

C3G

Overview C3G Infographic

In-Depth C3G Infographic

ISN-KDIGO Webinar Series on Complement in CKD

All of the recorded versions of the pre-webinar series leading up to KDIGO’s Controversies Conference on the Role of Complement in Kidney Disease can be found below.

Webinar 1: Dissecting the Role of Complement in Glomerulonephritis with a Focus on C3G

Webinar 2: What’s New in the Management and Treatment of GN: A look at ANCA and LN

Webinar 3: What’s New in the Management and Treatment of Glomerulonephritis: A look at IgAN and MN

Webinar 4: Role of Complement Beyond Glomerulonephritis (transplantation, DKD)

KDIGO Glomerular Diseases Guideline

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases (GD) and Additional Implementation Tools

This guideline is the most extensive in KDIGO history, organized into eleven chapters, ten of which cover a specific primary or secondary glomerular disease or group of diseases. The first chapter is an extensive review of general management principles that should be considered for patients with any type of glomerular disease.

Webinars, Articles and Additional Resources

ISN Global Kidney Care Podcast on CMKDs

In this podcast, Drs Namrata Parikh, Gary Chan and Nick Medjeral-Thomas discuss key clinical and pathology features of inappropriate, pathogenic complement activity that guide physicians to a diagnosis of C3 glomerulopathy. They discuss differences in investigation and management strategies between their respective clinical centers in Ottawa, Hong Kong and London, including access to clinical trials of therapeutic complement inhibitors. To finish, they speculated on the future impact on clinical nephrology of complement pathway analysis and inhibition.

ISN Quiz on Complement mediated Glomerulopathies

ISN October 2022 eDigest on CMKDs

ISN’s October ’22 eDigest presents recent publications in Kidney International Reports on the pathophysiology, progression, treatment, and validation of complement-mediated kidney diseases. It also highlights four original papers, in the field of complement-mediated kidney diseases, that have been published in Kidney International within the past few months. Explore the eDigest here.

ISN Frontiers Webinars

KDIGO 2015 CMKD Conference

Acknowledgments

Dr. Vladimír Tesař, Dr. Sydney Tang and Dr. Liz Lightstone provide expert guidance on the ongoing development of the toolkit; supported by Dr. Gary Chan, Dr. Namrata Parikh and Dr. Nicholas Medjeral-Thomas.

Vladimír Tesař

Vladimír Tesař is a head of the Department of Nephrology, 1st Faculty of Medicine, Charles University in Prague, Czech Republic. He is a member of the ISN Council Executive Committee and was chair of the Immunonephrology Working Group at ERA-EDTA from 2015 – 2021. He is the publications-author or co-author of more than 450 publications and is a member of the editorial board of Nephrology Dialysis Transplantation and Clinical Journal of the American Society of Nephrology.

Sydney Tang

Sydney Tang is currently Chair of Renal Medicine and Yu Professor in Nephrology at The University of Hong Kong. He is the President of the Asian Pacific Society of Nephrology, Executive Committee of KDIGO, and Chair of the CME Program Committee of the ISN. He is a past Chairman of the Hong Kong Society of Nephrology and serves the Hong Kong College of Physicians as Council Member (co-opt) and Secretary and Program Director (HK Island) of the Specialty Board in Nephrology.

Liz Lightstone

Liz Lightstone is Prof of Renal Medicine at Imperial College London. She is an elected member of the Women in Nephrology Executive Council. She is global co-chair of the SONG-GD steering committee, co-chairs the UK Kidney Research Consortium GN Clinical Study Group, established the Renal RaDar CKD and pregnancy rare disease group, is a member of the OMERACT 2022 SLE Working Group and the International Working Group on Glomerular Diseases and Pregnancy. She is a Trustee of Kidney Research UK and serves on their Research Strategy and Nominations and Governance Committees. She is a mentor on the 2021 ISN Emerging Leaders Programme.

Gary Chan

Gary Chan is currently an Associate Consultant and Honorary Clinical Assistant Professor at Queen Mary Hospital in Hong Kong, where he is in charge of the Acute Glomerulonephritis Clinic and the Genetic Kidney Disease Clinic. He is also the Training Programme Director for Nephrology at Hong Kong West Cluster Hospitals, Chair of the Young Nephrologist Committee of the Hong Kong Society of Nephrology and serves on the Continuing Medical Education Committee of the Asian Pacific Society of Nephrology.

Namrata Parikh

Namrata Parikh completed her nephrology training in India and is currently pursuing a fellowship in solid organ transplantation at The Ottawa Hospital, Ottawa, Canada. Her areas of interest are glomerular disease and kidney transplantation. She is a member of the @ISNEducation social media team, as well as a member of the Women in Nephrology – India social media team.

Nicholas Medjeral-Thomas

Nicholas Medjeral-Thomas is a kidney physician and clinician scientist at Imperial College London. His research focuses on the role of complement deregulation in C3 glomerulopathy and IgA nephropathy pathogenesis. He has made a number of important discoveries that improve our understanding of both these conditions. Most recently, he has investigated associations with and the potential pathogenic role of a protein called factor H related protein 5 (FHR5) in IgA nephropathy and C3 glomerulopathy. He has also investigated associations between lectin complement pathway proteins and COVID-19.

Support

This Complement-Mediated Kidney Diseases Toolkit is supported by Novartis.

Disclaimer text: This toolkit is intended to facilitate decision making of health professionals in their daily practice. However, final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. The ISN declines any responsibilities for any damage caused by the use that may be made of the information provided in this toolkit.