[Brussels, Belgium]—KDIGO is pleased to announce the publication of The Role of Complement in Kidney Disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference in Kidney International. The final version of the conference report was released digitally in July and will be published in the September issue of the journal. Co-chaired by Marina Vivarelli, MD (Italy) and Richard Smith, MD (United States) in Florence, Italy, in 2022, the conference gathered leading nephrologists, researchers, patients, and caregivers to discuss the latest evidence and future directions for managing complement-mediated kidney diseases.
The conference focused on the critical role of complement in various kidney diseases, particularly atypical hemolytic uremic syndrome (aHUS), C3 glomerulopathy (C3G), immune complex membranoproliferative glomerulonephritis, ANCA-associated vasculitis, IgA nephropathy, systemic lupus erythematosus, membranous nephropathy, focal segmental glomerulosclerosis (FSGS), and diabetic nephropathy. Attendees reviewed the latest evidence that complement plays a primary causal or secondary role in the progression of these diseases and explored how this understanding can inform more effective management strategies.
“The discussions at this conference were incredibly enlightening,” said Dr. Vivarelli. “We delved into the roles of complement in both rare and common kidney diseases, identifying knowledge gaps and setting research priorities. The evidence clearly shows that activation or dysregulation of complement plays a role in the pathogenesis of an increasing array of kidney diseases. While alternative pathway dysregulation is a main driver in aHUS and C3G, in other conditions like membranous nephropathy, diabetic kidney disease, and FSGS, complement plays a more nuanced role in perpetuating glomerular injury or contributing to chronic damage. With more therapeutic agents becoming available that target different parts of the complement cascade, it is vital that we improve our ability to identify the relevant pathway or protein involved in each patient, characterize its role, and determine the best course in ceasing the aberrant complement activity.”
The conference also underscored the importance of a global, coordinated, and collaborative approach to improving patient treatment options and outcomes. “It is clear that we need a concerted, multinational effort to make meaningful progress in our understanding and treatment of these mostly rare and heterogeneous kidney diseases,” said Dr. Smith. “We need to identify biomarkers of complement activation and dysregulation, standardize their measurement, and promote their global implementation. Data on complement biomarkers should be widely disseminated, and all stakeholders, including patient and caregiver associations, medical societies, health authorities, and pharmaceutical companies, must synergize to promote registries, biobanks, data sharing, and open access to trial results. This collaborative approach will enable us to offer early, accurate diagnosis and safe, effective, and affordable treatment tailored to individual patients.”
The patient voice was an essential aspect of the conference, with a patient and caregiver panel providing firsthand insights into living with complement-mediated kidney diseases. “The presence of patients and their caregivers was invaluable,” said Dr. Vivarelli. “Their stories and experiences brought a profound human element to our discussions by reminding us of the real-world implications of our research and the importance of patient-centered care. Their contributions emphasized the need for therapies that address the medical aspects of these diseases and improve the quality of life for those affected.”
Download the conference report on the KDIGO or Kidney International websites.
