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If you have C3 glomerulopathy (C3G) or immune complex-mediated membranoproliferative glomerulonephritis (IC-MPGN), the goal of treatment is generally to slow down kidney damage over time.
But how do you know if your treatment is making a difference, especially if you don’t feel different right away? In this article, we’ll explain how treatments may help, how your healthcare team measures changes in kidney health, and what signs they may monitor over time.
To understand how to know if a treatment is working, it’s helpful to first understand the main types of treatment used to manage C3G and IC-MPGN.
The goals of treatment often include:
Understanding what each treatment is meant to do can make it easier to recognize signs of progress over time.
Healthy kidneys have tiny filters called glomeruli. These filters remove waste and extra fluid from the blood while keeping needed proteins in the bloodstream. When the glomeruli are damaged, protein can leak into the urine. This is called proteinuria, and it may make urine look foamy or bubbly.
If you have C3G or IC-MPGN, you may take medications that help protect kidney function and reduce protein loss in the urine. Blood pressure medications, such as ACE inhibitors and angiotensin-receptor blockers (ARBs), are often used for this purpose. They help the kidneys by reducing the physical pressure inside the glomeruli.
In C3G and IC-MPGN, different immune system problems can damage the glomeruli. In C3G, the complement system (a group of immune proteins) becomes overactive. In IC-MPGN, antibodies attach to other substances and form clumps called immune complexes.
Normally, the immune system responds to germs that enter the body and cause an infection. In C3G, complement proteins build up in the glomeruli. In IC-MPGN, immune complexes become trapped there. Both processes can cause inflammation and damage the glomeruli and nearby kidney tissue.
You may be treated with immunosuppressive medications such as corticosteroids or mycophenolate mofetil. These medications reduce immune system activity and may help to limit inflammation and kidney damage. Because they affect the immune system, they can raise the risk of infection, so your healthcare team will monitor you during treatment.
Immunosuppressants may be considered when C3G or IC-MPGN is more active or severe, such as when kidney function continues to decline.
Immunosuppressive medications, such as corticosteroids, can help reduce inflammation, but they affect the immune system broadly. Complement inhibitors target specific parts of the complement system. This approach may help reduce kidney damage caused by abnormal complement activity in C3G and some cases of IC-MPGN.
Complement inhibitors work by blocking specific proteins in the complement system that contribute to inflammation and kidney damage. Examples of complement inhibitors approved by the U.S. Food and Drug Administration (FDA) include iptacopan for adults with C3G and pegcetacoplan for adults and children 12 and older with C3G or primary IC-MPGN. Both are approved to reduce proteinuria.
Because the complement system also helps the body fight infections, people taking complement inhibitors may need close monitoring while on treatment.
C3G and IC-MPGN often change gradually over weeks or months, so it can take time to tell whether treatment is working. Your healthcare team will look at test results, symptoms, and trends over time to see how your kidneys are responding.
Signs that treatment may be helping include:
Even if you start to feel better, it’s important to continue to take your medications as prescribed and keep your kidney follow-up appointments. Much of the information showing whether treatment is working comes from routine kidney check-in appointments and laboratory testing.
Regular check-ins help your healthcare team track your kidney health and look for changes over time. During these visits, they may review your symptoms, check your blood pressure, discuss your medications, and order blood or urine tests.
Some of the tests you may see include:
It’s important to remember that kidney specialists look at your symptoms and test results together. No single test gives a complete picture of how well your kidneys are working or whether treatment is helping. For example, some people with C3G may have low serum C3 levels and positive tests for C3NeF, while others do not.
Your healthcare team will look at laboratory result trends over time along with how you are feeling to get the most complete picture of your health.
As you get older, taking greater responsibility for your health can feel overwhelming at times. Some ways to take charge of your care include:
Taking charge of your care also means knowing when to ask for help. It’s important to pay attention to changes in your symptoms and know when to contact your healthcare team.
If you are living with C3G or IC-MPGN and you notice a new symptom or change that is concerning, contact your healthcare team with questions. You don’t need to wait until your next appointment.
Contact your healthcare team if you notice:
You should also contact your healthcare team if you have trouble getting medication refills or have concerns about how school, work, sports, travel, insurance, or other activities may affect your care. It’s better to ask questions early than to wait and worry on your own.
On MyKidneyDiseaseTeam, people share their experiences with kidney conditions, get advice, and find support from others who understand.
How do you know when your treatment is working, and what signs do you pay attention to the most? Let others know in the comments below.
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