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Updated: Nov 11, 2025

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Complement and kidney disease, new insights

Nicholas R Medjeral-Thomas1, Matthew C Pickering, H Terence Cook

  • 1Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, UK.

Current Opinion in Nephrology and Hypertension
|March 26, 2021
PubMed

Insights

The complement pathway is crucial in kidney diseases like C3 glomerulopathy and IgA nephropathy. Targeting complement activation offers potential therapeutic strategies for these conditions.

Area of Science:

  • Nephrology
  • Immunology
  • Molecular Medicine

Background:

  • The complement system, a key part of innate immunity, plays an increasingly recognized role in the pathogenesis of various kidney diseases.
  • Dysregulation of complement activation is implicated in conditions such as C3 glomerulopathy (C3G), IgA nephropathy (IgAN), and thrombotic microangiopathy.

Purpose of the Study:

  • To review recent studies highlighting the significance of the complement pathway in kidney disease.
  • To discuss the pathogenic insights and therapeutic potential derived from understanding complement's role.

Main Methods:

  • Review of recent scientific literature focusing on complement activation in kidney diseases.
  • Analysis of immunohistochemical findings, genetic associations, and clinical data in C3G and IgAN.
  • Examination of therapeutic studies involving complement inhibitors.

Main Results:

  • In C3G, factor H related protein 5 (FHR5) deposition correlates with kidney function, and mycophenolate mofetil (MMF) shows therapeutic promise.
  • In IgAN, imbalances in factor H (FH) and FHR proteins (FHR1, FHR5) are associated with disease severity, alongside contributions from the lectin complement pathway.
  • Complement activation is evident across diverse kidney diseases, indicating its broad pathogenic relevance.

Conclusions:

  • The complement pathway is a critical factor in the development and progression of multiple kidney diseases.
  • Understanding complement dysregulation provides valuable pathogenic insights and identifies targets for novel therapies.
  • Ongoing drug development targeting complement activation holds significant therapeutic potential for kidney disease patients.
Abstract

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