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Clinical Profile and Outcome of C3-Dominant Glomerulonephritis: Retrospective Study

Vishrut Khullar1, Attur Ravindra Prabhu2, Shankar Prasad Nagaraju1

  • 1Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.

Kidney & Blood Pressure Research
|January 12, 2026
PubMed

Insights

C3-dominant glomerulonephritis (GN) affects over 6% of kidney biopsies, often presenting with nephrotic proteinuria and kidney failure. While many achieve remission, a significant portion progresses to end-stage kidney disease (ESKD) or mortality.

Area of Science:

  • Nephrology
  • Immunology
  • Pathology

Background:

  • C3-dominant glomerulonephritis (GN) encompasses rare disorders like C3 glomerulopathy (C3G) and infection-related GN (IRGN), stemming from alternative complement pathway dysregulation.
  • Long-term follow-up data for C3-dominant GN is scarce, necessitating studies on clinical profiles and outcomes.

Purpose of the Study:

  • To investigate the clinical, pathological profiles, and outcomes of patients diagnosed with C3-dominant GN.
  • To analyze treatment strategies and complications associated with C3-dominant GN.

Main Methods:

  • A single-center, retrospective observational study analyzed kidney biopsy data from 2013 to 2023.
  • Data collected included demography, laboratory results, histopathology, treatment, and patient outcomes.

Main Results:

  • C3-dominant GN constituted 6.48% of kidney biopsies (141 cases), with C3G and IRGN being the primary subtypes.
  • Patients often presented with impaired kidney function (eGFR <60ml/min/1.73m2 in 64.5%), nephrotic proteinuria (46%), and low serum C3 levels (78.7%).
  • Remission was achieved in 58% of patients, while 22% progressed to end-stage kidney disease (ESKD), and 19.1% died during an average follow-up of 25.7 months.

Conclusions:

  • C3-dominant GN is a significant finding in kidney biopsies, frequently associated with severe clinical presentations and poor outcomes.
  • Factors like diabetes mellitus, glomerular sclerosis, and crescents predict progression to CKD stage 5.
  • Immunosuppression treatment was associated with infections, notably pneumonia.
Abstract

Keywords:
C3 glomerulonephritisC3 glomerulopathyC3-dominant glomerulonephritisComplement 3Infection-related glomerulonephritis

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