Uncontrolled complement activation can cause or contribute to glomerular injury in multiple kidney diseases. Although complement activation plays a causal role in atypical hemolytic uremic syndrome and C3 glomerulopathy, over the past decade, a rapidly accumulating body of evidence has shown a role for complement activation in multiple other kidney diseases, including diabetic nephropathy and several glomerulonephritides. The number of available complement inhibitor therapies has also increased during the same period. In 2022, Kidney Diseases: Improving Global Outcomes (KDIGO) convened a Controversies Conference, “The Role of Complement in Kidney Disease,” to address the expanding role of complement dysregulation in the pathophysiology, diagnosis, and management of various glomerular diseases, diabetic nephropathy, and other forms of hemolytic uremic syndrome. Conference participants reviewed the evidence for complement playing a primary causal or secondary role in progression for several disease states and considered how evidence of complement involvement might inform management. Participating patients with various complement-mediated diseases and caregivers described concerns related to life planning, implications surrounding genetic testing, and the need for inclusive implementation of effective novel therapies into clinical practice. The value of biomarkers in monitoring disease course and the role of the glomerular microenvironment in complement response were examined, and key gaps in knowledge and research priorities were identified.

中文翻译：

---

补体在肾脏疾病中的作用：肾脏疾病：改善全球成果 (KDIGO) 争议会议的结论


不受控制的补体激活可导致或导致多种肾脏疾病中的肾小球损伤。尽管补体激活在非典型溶血性尿毒症综合征和 C3 肾小球病中发挥着因果作用，但在过去十年中，快速积累的证据表明补体激活在多种其他肾脏疾病中发挥着作用，包括糖尿病肾病和几种肾小球肾炎。同期可用补体抑制剂疗法的数量也有所增加。 2022 年，肾脏疾病：改善全球成果 (KDIGO) 召开了一场争议性会议，“补体在肾脏疾病中的作用”，以解决补体失调在各种肾小球疾病、糖尿病肾病的病理生理学、诊断和治疗中日益扩大的作用，以及其他形式的溶血性尿毒症综合征。会议与会者回顾了补体在几种疾病状态进展中发挥主要因果或次要作用的证据，并考虑了补体参与的证据如何为管理提供信息。患有各种补体介导疾病的参与患者和护理人员描述了与生活规划相关的担忧、基因检测的影响以及将有效的新型疗法纳入临床实践的必要性。检查了生物标志物在监测疾病过程中的价值以及肾小球微环境在补体反应中的作用，并确定了知识和研究重点方面的关键差距。