The Rational Use of Complement Inhibitors in Kidney Diseases

The development of complement inhibitors represented one of the major breakthroughs in clinical nephrology in the last decade. Complement inhibition has dramatically transformed the outcome of one of the most severe kidney diseases, the atypical hemolytic uremic syndrome (aHUS), a prototypic complement-mediated disorder. The availability of complement inhibitors has also opened new promising perspectives for the management of several other kidney diseases in which complement activation is involved to a variable extent. With the rapidly growing number of complement inhibitors tested in a rapidly increasing number of indications, a rational use of this innovative and expensive new therapeutic class has become crucial. The present review aims to summarize what we know, and what we still ignore, regarding complement activation and therapeutic inhibition in kidney diseases. It also provides some clues and elements of thoughts for a rational approach of complement modulation in kidney diseases.

Automated summary

The development of complement inhibitors has brought about significant advancements in the field of clinical nephrology, particularly in the treatment of severe kidney diseases such as atypical hemolytic uremic syndrome. The availability of these inhibitors has also opened up new possibilities for managing other kidney diseases where complement activation is involved. However, the rational usage of these costly therapeutic agents is crucial, especially with the increasing number of inhibitors being tested for various indications. This review aims to summarize the current knowledge and gaps regarding complement activation and therapeutic inhibition in kidney diseases, while providing insights for a rational approach to complement modulation.