Drs Namrata Parikh, Gary Chan and Nick Medjeral-Thomas are nephrologists and complement enthusiasts interested in the diagnosis and management of complement mediated kidney diseases. In this conversation, we discussed key clinical and pathology features of inappropriate, pathogenic complement activity that guide physicians to a diagnosis of C3 glomerulopathy. We discussed differences in investigation and management strategies between our respective clinical centers in Ottawa, Hong Kong and London, including access to clinical trials of therapeutic complement inhibitors. To finish, we speculated on the future impact on clinical nephrology of complement pathway analysis and inhibition.