C3 Glomerulonephritis at the crossroads of Diabetes and Renal Failure: A Case Report

Abstract

C3 glomerulopathy (C3G) is a rare complement-mediated kidney disease characterized by dominant C3 deposition in the glomeruli, with C3 glomerulonephritis (C3G) and dense deposit disease (DDD) as its two main subtypes. We present the case of a 66-year-old female with known C3G on maintenance hemodialysis, complicated by diabetes, hypertension, and diabetic foot ulcer. She had large hematuria, significant proteinuria, severe renal failure, and a noticeably increased serum creatinine level. In addition to early diabetic nephropathy and chronic renal alterations, kidney biopsy confirmed C3GN with a diffuse endocapillary proliferative pattern, crescent development, significant C3 deposition, and lack of immunoglobulins. Hemodialysis, antihypertensives, steroids, renal-supportive drugs, and insulin treatment were used to treat her. In addition to highlighting the difficulties in treating advanced C3G, this case adds to the limited information on this rare illness and underscores the diagnostic value of kidney biopsies.