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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
C3 glomerulopathy (C3G) is a complement-mediated glomerular disease with heterogenous presentations and outcomes. It is uncommon in adolescents, with limited data from South Asia. We describe clinical, laboratory and histopathological profile and early outcomes of adolescents with biopsy-proven C3G cohort from a tertiary centre from Eastern India.
This retrospective observational study (2012-2023), included all adolescents (10-18 years) with biopsy proven C3G and ≥6 months follow-up. C3G-was defined by dominant C3 staining on immunofluorescence with minimal immunoglobulins; electron microscopy (EM-when available) supported complement-mediated deposits and further subtyped lesions as C3 glomerulonephritis (C3GN) and Dense Deposit Disease (DDD). Demographic, clinical, laboratory, and histopathologic parameters, and treatment outcomes were analysed descriptively. Treatment was given as per nephrologist discretion.
During this time-period 438 adolescent (10-18 years) kidney biopsies were done out of which 27 (6.2%) patients were diagnosed as C3G. Mean age was 16.31± 1.98 years; males predominated (63%). Nephrotic syndrome was most frequent presentation (67% n=18), followed by RPRF (Rapidly progressive renal failure- 26%, n=7), and 3.7% each as AKI (Acute kidney Injury) and CKD (chronic kidney disease).
Mean 24-h proteinuria averaged 5.06± 1.04 g/day, with nephrotic-range proteinuria in 25/27 (92.6%), hypoalbuminemia (<3.0g/dl) in 16/27 cases, and mean serum creatinine at presentation was 3.32 mg/dl. Low C3 levels were noted in 46.2% cases.
Histopathologically, crescents were present in 8/27 (29.6%), IFTA ≥ 10% in 96%, and sclerosis ≥ 10% in41%, indicating significant chronicity. EM was done in 20/27 (74.07%), and DDD was diagnosed in 4/27 (14.81%) cases.
Overall, 10/27 (37%) achieved remission with treatment (2 complete, 8 partial), while 10 (37%) progressed to CKD, largely among RPRF cases (6/7), mortality (14.8%) seen across all severe presentations. The Nephrotic group had the best response (55.5% CR+PR), while RPRF and AKI/CKD groups uniformly showed poor outcomes in terms of kidney/patient survival.
Interpretation
Adolescent C3G demonstrates a bimodal clinical course: an immune-mediated nephrotic phenotype with remission potential and a crescentic, rapidly progressive form with poor outcomes. Despite nephrotic predominance, one-third progressed to CKD. High IFTA and sclerosis frequencies reflect delayed referral and chronic complement activation. The limited complement evaluation underscores the need for standardized complement assays and targeted therapy in resource-limited settings.
In our study adolescents with C3G presented predominantly with nephrotic syndrome (67%), followed by RPRF. Although nephrotic onset had better remission rates, over one-third progressed to CKD. Mortality and CKD risks were markedly higher among non-nephrotic presentations (RPRF/AKI/CKD).
These data reflect the bimodal course of C3G- an immunologic nephrotic form with remission potential versus a rapidly progressive crescentic form with poor kidney survival.
