An Italian Delphi consensus on the epidemiology, characteristics, and management of C3 glomerulopathy
4 affiliations
- 1Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital and University of Turin
- 2Bicocca Applied Statistics Center (B-ASC), University of Milano-Bicocca
- 3Department of Clinical Sciences and Community Health, University of Milan
- 4Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico
Abstract
Background: C3 glomerulopathy (C3G) is a chronic kidney disease previously included within the broader spectrum of membranoproliferative glomerulonephritis. Information on various aspects of C3G, including epidemiology, management, and patient needs, is extremely scarce at the international and particularly at a national level.
Methods: Between April 2024 and February 2025, we conducted an online iterative modified Delphi study involving Italian nephrologists with expertise in C3G. The Delphi study was performed according to the best practices for defining consensus and was reported following the ACcurate COnsensus Reporting Document (ACCORD) guidelines. Five main areas of investigation of C3G were explored, i.e., epidemiology, patient characteristics, disease outcomes, treatment, and other mixed aspects.
Results: Of the 23 invited clinicians, 2 (8.7%) did not reply and 4 (17.4%) did not satisfy the inclusion criteria defined by the Steering Committee. Thus, the voting panel included 17 Italian experts. Two iterations were required to complete the Delphi study. All 17 panellists participating to the first iteration completed the second Delphi round. Agreement was achieved on an estimated number of 60–90 incident patient per year (94% agreement) and about 2700 prevalent cases of C3G (82% agreement) in Italy. The stabilization of eGFR and an improvement in proteinuria emerged as key disease and treatment outcomes. All experts agreed that the availability of specific and effective treatments and rapid and correct disease diagnosis are currently the most important unmet needs related to C3G.
Conclusions: This investigation provided relevant information for improving our knowledge of C3G, stimulate discussion and enhance research on this ultra-rare disease in Italy.
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BibTeX
@article{biancone2026italian,
title = {{An Italian Delphi consensus on the epidemiology, characteristics, and management of C3 glomerulopathy}},
author = {Luigi Biancone and Carlotta Galeone and Paolo Mariani and Claudio Pelucchi and Giuseppe Castellano},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1842797},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1842797/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - An Italian Delphi consensus on the epidemiology, characteristics, and management of C3 glomerulopathy
AU - Luigi Biancone
AU - Carlotta Galeone
AU - Paolo Mariani
AU - Claudio Pelucchi
AU - Giuseppe Castellano
PY - 2026
DA - 2026/10/19
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1842797
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1842797/full
AB - Background: C3 glomerulopathy (C3G) is a chronic kidney disease previously included within the broader spectrum of membranoproliferative glomerulonephritis. Information on various aspects of C3G, including epidemiology, management, and patient needs, is extremely scarce at the international and particularly at a national level. Methods: Between April 2024 and February 2025, we conducted an online iterative modified Delphi study involving Italian nephrologists with expertise in C3G. The Delphi study was performed according to the best practices for defining consensus and was reported following the ACcurate COnsensus Reporting Document (ACCORD) guidelines. Five main areas of investigation of C3G were explored, i.e., epidemiology, patient characteristics, disease outcomes, treatment, and other mixed aspects. Results: Of the 23 invited clinicians, 2 (8.7%) did not reply and 4 (17.4%) did not satisfy the inclusion criteria defined by the Steering Committee. Thus, the voting panel included 17 Italian experts. Two iterations were required to complete the Delphi study. All 17 panellists participating to the first iteration completed the second Delphi round. Agreement was achieved on an estimated number of 60–90 incident patient per year (94% agreement) and about 2700 prevalent cases of C3G (82% agreement) in Italy. The stabilization of eGFR and an improvement in proteinuria emerged as key disease and treatment outcomes. All experts agreed that the availability of specific and effective treatments and rapid and correct disease diagnosis are currently the most important unmet needs related to C3G. Conclusions: This investigation provided relevant information for improving our knowledge of C3G, stimulate discussion and enhance research on this ultra-rare disease in Italy.
SN - 1664-3224
ER -