C3G in Pediatric Patients

EP: 1.An overview of IgA Nephropathy

EP: 2.IgA Nephropathy in Different Ethnic Populations

EP: 3.IgA Nephropathy in the Transplant Population

EP: 4.IgA Nephropathy in Pediatric Patients

EP: 5.An Overview of C3G

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EP: 6.C3G in Pediatric Patients

EP: 7.Challenges of Managing C3G

EP: 8.Consequences of a Late or Missed Diagnosis of C3G

EP: 9.Differential Diagnosis of C3G

EP: 10.The Pathology of IgAN on Kidney Biopsy

EP: 11.The role of electro microscopy in the diagnosis of IgAN

EP: 12.Kidney biopsy as a guide for treatment and prognosis

EP: 13.Diagnostic testing in C3G

EP: 14.Diagnosing C3G in pediatric patients

EP: 15.Kidney biopsy C3G

EP: 16.Building expertise in C3G

EP: 17.Clues to C3G in a biopsy

EP: 18.Barriers to kidney biopsy

EP: 19.Current standard of care for C3G

EP: 20.Clinical trial data on complement inhibition in C3G

EP: 21.Complement therapy in transplant patients in C3G

EP: 22.Clinical trial data on IgAN for therapies

Jonathan Barratt, PhD, FRCP: I'm glad we've got Sanjeev here and we'll come to the kidney biopsy in a short while. But just a final question, again, as an adult nephrologist, I'm fascinated by how children behave. I only see children who transition through to the adult clinic. Do children behave in a different way to adults in terms of this disease, or do you think there are similarities here?

Carla M. Nester, MD, MSA, FASN: It depends on which cohort you look at; we used to believe that children were going to have the most aggressive disease, and the variant called dense deposit disease was going to be the most aggressive disease. But it turns out that regardless of whether it's dense deposit disease or C3 glomerulonephritis, the disease can be very active. And that's one of the unmet needs for a practicing glomerular physician is, is this idea of not knowing who or how to tell who is going to do very poorly. Who requires the most aggressive of your therapies? I would say that children present very similar glomerular diseases, except for they might be a little bit more likely to have nephrotic syndrome. They are certainly more likely to be damaged by the loss of their kidney function. Not only because they have growth to take care of, but they have all the normal body functions they need to take care of, but also because they're going to be headed for 1, maybe 2, even more transplants, frankly, because of the sheer risk for recurrence.

Jonathan Barratt, PhD, FRCP: And with children affected both with IgA nephropathy and C3G, we think we focus very much on the medical aspects of these diseases, but clearly, this impacts on education, it impacts on social skill development, it impacts on whole range of different things that as adult nephrologists, we don't tend to concentrate so much on. What kinds of experience have you had of that?

Carla M. Nester, MD, MSA, FASN: That's a very good point that we shouldn't forget, but we sometimes do. It affects the patient's self-worth if you - they worry that I've got this very rare renal disease, or I've got this untreatable renal disease. And I think that with the younger mind not being able to completely understand what impact this may have on them, it can be very traumatic for them, like you said, socially or even within their normal growth patterns, if you will.

Transcript Edited for Clarity