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A Guide for Adult Nephrologists and Hematologists to Managing Atypical Hemolytic Uremic Syndrome and C3 Glomerulopathy in Teens Transitioning to Young Adults

  • Magdalena Riedl Khursigara
    Affiliations
    Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada
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  • Mina Matsuda-Abedini
    Affiliations
    Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada

    Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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  • Seetha Radhakrishnan
    Affiliations
    Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada

    Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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  • Michelle A. Hladunewich
    Affiliations
    Division of Nephrology and Obstetric Medicine, Department of Medicine, Sunnybrook Health Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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  • Mathieu Lemaire
    Affiliations
    Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada

    Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Cell Biology Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
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  • Chia Wei Teoh
    Affiliations
    Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada

    Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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  • Damien Noone
    Affiliations
    Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada

    Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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  • Christoph Licht
    Correspondence
    Address correspondence to Christoph Licht, MD, FRCPC, FASN, Division of Nephrology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G1X8, Canada.
    Affiliations
    Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada

    Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Cell Biology Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
    Search for articles by this author
      Atypical hemolytic uremic syndrome and C3 glomerulopathy/immune complex membranoproliferative glomerulonephritis are ultra-rare chronic, complement-mediated diseases with childhood manifestation in a majority of cases. Transition of clinical care of patients from pediatric to adult nephrologists—typically with controlled disease in native or transplant kidneys in case of atypical hemolytic uremic syndrome and often with chronic progressive disease despite treatment efforts in case of C3 glomerulopathy/immune complex membranoproliferative glomerulonephritis—identifies a challenging juncture in the journey of these patients. Raising awareness for the vulnerability of this patient cohort; providing education on disease pathophysiology and management including the use of new, high-precision complement antagonists; and establishing an ongoing dialog of patients, families, and all members of the health care team involved on either side of the age divide will be inevitable to ensure optimal patient outcomes and a safe transition of these patients to adulthood.

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