{
  "abstract": "Background: Despite the key pathogenetic role of the complement cascade in various immune-mediated kidney diseases, the clinical significance of serum C3/C4 levels in conditions where most patients exhibit complement levels within normal limits, such as membranous nephropathy (MN) and ANCA (antineutrophil cytoplasmic antibody)-glomerulonephritis (ANCA-GN), remains underexplored. This study focused on the clinico-pathological correlates of serum complement C3/C4 levels in two cohorts of patients with biopsy-proven MN and ANCA-GN.\n\nMethods: Based on median C3 and C4 levels at time of diagnostic biopsy, the cohorts were stratified into four groups, referred to as “complement component-high” and “-low.” Clinico-pathological features were compared between these groups and correlated with C3/C4 levels.\n\nResults: In the MN cohort (n = 44), patients in the C3-low group showed a higher degree of global (8.3% vs 0%, p = .015) and combined global and segmental glomerulosclerosis (9.5% vs 0%, p = .032) compared to the C3-high group. In the ANCA-GN cohort (n = 198), serum C3 levels were lower in cases with the sclerotic class according to Berden classification (107 [98–123] mg/dl) compared to those classified as focal (138 [112–151] mg/dl, p < .001), crescentic (127 [107–151] mg/dl, p = .003), or mixed (123 [101–140] mg/dl, p = .018). Furthermore, ANCA-GN patients in the C3-low group showed lower estimated glomerular filtration rate at presentation and serum C3 was inversely associated with the risk of kidney failure, independently of several confounders (Hazard ratio [HR] for 10 mg/dl increase in C3: 0.91, 95% Confidence Interval [CI] 0.83–1.00, p = .049).\n\nConclusions: Serum C3 levels in the low-normal range were associated with glomerulosclerosis in both ANCA-GN and MN, and with poorer kidney outcome in ANCA-GN, supporting a potentially cross-disease role of the complement cascade in mediating glomerular injury.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 41,
  "authors": [
    {
      "name": "Martina Tedesco"
    },
    {
      "name": "Elisa Delbarba"
    },
    {
      "name": "Martina Uzzo"
    },
    {
      "name": "Gianmarco Lugli"
    },
    {
      "name": "Chiara Bedognè"
    },
    {
      "name": "Marta Salti"
    },
    {
      "name": "Francesco Ravelli"
    },
    {
      "name": "Corrado Damilano"
    },
    {
      "name": "Eva Sestagalli"
    },
    {
      "name": "Marta Arrighini"
    },
    {
      "name": "Simona Fisogni"
    },
    {
      "name": "Vincenzo L’Imperio"
    },
    {
      "name": "Fabio Pagni"
    },
    {
      "name": "Jennifer Scott"
    },
    {
      "name": "Jennifer Scott"
    },
    {
      "name": "Jennifer O’Brien"
    },
    {
      "name": "Kresimir Galesic"
    },
    {
      "name": "Simonetta Genovesi"
    },
    {
      "name": "Giorgio Trivioli"
    },
    {
      "name": "Marco Allinovi"
    },
    {
      "name": "Iva Gunnarsson"
    },
    {
      "name": "Anna Juto"
    },
    {
      "name": "Robert Hall"
    },
    {
      "name": "Silke R. Brix"
    },
    {
      "name": "Federica Maritati"
    },
    {
      "name": "Anisa Idrizi"
    },
    {
      "name": "Anna Ricchiuto"
    },
    {
      "name": "Annette Bruchfeld"
    },
    {
      "name": "Gaetano La Manna"
    },
    {
      "name": "Mario Cozzolino"
    },
    {
      "name": "Renato A Sinico"
    },
    {
      "name": "Augusto Vaglio"
    },
    {
      "name": "Giacomo Emmi"
    },
    {
      "name": "Ingeborg Bajema"
    },
    {
      "name": "Andreas Kronbichler"
    },
    {
      "name": "Matija Crnogorac"
    },
    {
      "name": "Stephen McAdoo"
    },
    {
      "name": "Mark A Little"
    },
    {
      "name": "David R W Jayne"
    },
    {
      "name": "Federica Mescia"
    },
    {
      "name": "Federico Alberici"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/93zabqk2r1xx8.bib",
  "cited_by": 0,
  "doi": "10.1093/ckj/sfag350",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13724270/?tool=EBI",
  "id": "93zabqk2r1xx8",
  "issns": [
    "2048-8505",
    "2048-8513"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13724270",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00340"
    ],
    [
      "heading",
      "General Clinical Nephrology"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2727|Renal Diseases and Glomerulopathies"
    ]
  ],
  "openalex": "W7220705819",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13724270/pdf/?tool=EBI",
  "pmcid": "PMC13724270",
  "pmid": "42973527",
  "published": "2026-10-05",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/93zabqk2r1xx8.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13724270",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13724270"
    },
    {
      "first_seen": "2026-11-04T12:22:52Z",
      "native_id": "PMC13724270",
      "source": "pmc",
      "url": "https://doi.org/10.1093/ckj/sfag350"
    },
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42973527",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42973527"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Renal Diseases and Glomerulopathies",
      "subfield": "general"
    }
  ],
  "title": "Lower serum C3 levels are associated with glomerulosclerosis in membranous nephropathy and ANCA-glomerulonephritis",
  "title_text": "Lower serum C3 levels are associated with glomerulosclerosis in membranous nephropathy and ANCA-glomerulonephritis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:20:49Z",
  "url": "https://research.draconitic.com/paper/93zabqk2r1xx8",
  "venue": "Clinical kidney journal",
  "versions": []
}