{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T09:27:30Z","timestamp":1787045250275,"version":"build-2736575974"},"reference-count":63,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100031645","name":"Novartis Farma s.p.a","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100031645","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>C3 glomerulopathy (C3G) includes dense deposit disease and C3 glomerulonephritis, both of which can be associated with membranoproliferative glomerulonephritis. The prevalence and true burden of C3G in Italy is difficult to estimate due to the rarity of the disease and a lack of epidemiological and patient-reported data. Moreover, diagnosis of C3G is challenging and complex due to its nonspecific clinical characteristics, a continually evolving disease classification, and the need for careful interpretation of immunofluorescence, light microscopy and electron microscopy kidney biopsy findings. Here, we provide a narrative review of the relevant literature, along with 38 consensus statements specific to the Italian context that were developed by an eight-member scientific advisory board, and voted on by a 42-member expert panel, with consensus reached using Delphi methodology. We outline the patient journey and management of C3G in Italy, highlighting ways of improving the current pathway, and suggesting steps to improve our understanding of the disease. The consensus statements cover: epidemiology of C3G in Italy; classification of C3G; histology and diagnostic procedures; management of patient symptoms; the patient journey in C3G in terms of diagnosis, treatment and follow-up; and disease burden and quality of life. Two rounds of voting were conducted, and consensus (at least 66.6% of panelists voting agree\/strongly agree on a 4-point Likert scale) was reached for all statements. These consensus statements, while specific to the Italian context, are broadly applicable globally and provide an overview of this rare disease as well as the necessary diagnostic steps.<\/jats:p>","DOI":"10.1093\/joneph\/aajag170","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:49:44Z","timestamp":1782388184000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis and management of C3 glomerulopathy in Italy: a Delphi consensus"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4419-6813","authenticated-orcid":false,"given":"Dario","family":"Roccatello","sequence":"first","affiliation":[{"name":"University Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, San Giovanni Bosco Hub Hospital , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7700-6350","authenticated-orcid":false,"given":"Luigi","family":"Biancone","sequence":"additional","affiliation":[{"name":"Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Citt\u00e0 Della Salute e Della Scienza Hospital, University of Turin , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3566-1995","authenticated-orcid":false,"given":"Antonella","family":"Barreca","sequence":"additional","affiliation":[{"name":"Pathology Unit, Citt\u00e0 della Salute e della Scienza di Torino University Hospital , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4861-0911","authenticated-orcid":false,"given":"Loreto","family":"Gesualdo","sequence":"additional","affiliation":[{"name":"University Aldo Moro of Bari Department of Precision and Regenerative Medicine and Jonian Area (DIMEPRE-J), , Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-2177","authenticated-orcid":false,"given":"Giuseppe","family":"Grandaliano","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University of Sacred Heart , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-8551","authenticated-orcid":false,"given":"Gaetano","family":"La Manna","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, Alma Mater Studiorum - University of Bologna , Bologna ,","place":["Italy"]},{"name":"IRCCS\u2014Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola Malpighi Hospital , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2811-7887","authenticated-orcid":false,"given":"Antonello","family":"Pani","sequence":"additional","affiliation":[{"name":"Department of Reproduction, Genitourinary System, Kidney Diseases and Transplantation, University of Cagliari , Cagliari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1686-5709","authenticated-orcid":false,"given":"Federico","family":"Alberici","sequence":"additional","affiliation":[{"name":"Nephrology Unit, University of Brescia, ASST Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026081804410076600_aajag170-B1","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1038\/nrneph.2010.85","article-title":"C3 glomerulopathy: a new classification","volume":"6","author":"Fakhouri","year":"2010","journal-title":"Nat Rev Nephrol"},{"key":"2026081804410076600_aajag170-B2","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1038\/ki.2012.80","article-title":"C3 glomerulopathy: what's in a name?","volume":"82","author":"D'Agati","year":"2012","journal-title":"Kidney Int"},{"key":"2026081804410076600_aajag170-B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.smim.2022.101634","article-title":"Complement C3-targeted therapy in C3 glomerulopathy, a prototype of complement-mediated kidney diseases","volume":"60","author":"Meuleman","year":"2022","journal-title":"Semin Immunol"},{"key":"2026081804410076600_aajag170-B4","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1038\/ki.2013.377","article-title":"C3 glomerulopathy: consensus report","volume":"84","author":"Pickering","year":"2013","journal-title":"Kidney Int"},{"key":"2026081804410076600_aajag170-B5","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1016\/j.kint.2017.10.022","article-title":"C3 glomerulonephritis and dense deposit disease share a similar disease course in a large United States cohort of patients with C3 glomerulopathy","volume":"93","author":"Bomback","year":"2018","journal-title":"Kidney Int"},{"key":"2026081804410076600_aajag170-B6","doi-asserted-by":"publisher","first-page":"659","DOI":"10.34067\/kid.0000000000000115","article-title":"Clinical profiles and patterns of kidney disease progression in C3 glomerulopathy","volume":"4","author":"Caravaca-Font\u00e1n","year":"2023","journal-title":"Kidney360."},{"key":"2026081804410076600_aajag170-B7","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1038\/ki.2012.63","article-title":"Acquired and genetic complement abnormalities play a critical role in dense deposit disease and other C3 glomerulopathies","volume":"82","author":"Servais","year":"2012","journal-title":"Kidney Int"},{"key":"2026081804410076600_aajag170-B8","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.1681\/asn.2007030356","article-title":"New approaches to the treatment of dense deposit disease","volume":"18","author":"Smith","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"2026081804410076600_aajag170-B9","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1038\/s41581-018-0107-2","article-title":"C3 glomerulopathy - 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