Clinico-Pathological Outcomes of Patients With Crescentic Glomerulonephritis: A Single-Center Study

Abstract

Background Crescentic glomerulonephritis (CrGN) is a pathological description of rapidly progressive glomerulonephritis (RPGN). It is characterized by renal failure and is associated with a grave prognosis. This study aimed to investigate the clinical outcomes of patients diagnosed with crescentic glomerulonephritis at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Method This retrospective study included patients with CrGN who underwent treatment at the nephrology department at KAUH from June 2021 to August 2022. We collected and analyzed data from 56 patients diagnosed with CrGN on the basis of renal biopsies between 2002 and 2015. Result The study included 17 cases of CrGN. The mean age of patients at the time of diagnosis was 18.06 ± 13.49 years. The distribution of histological findings showed that cellular crescents (94.1%) and interstitial fibrosis and tubular atrophy (IFTA) (76.5%) were the most commonly observed histological findings. The most common underlying etiology was lupus nephritis (41.2%). Regarding the lab results, the mean serum creatinine level at admission was 378.88 ± 273.27 μmol/L, proteinuria was 1.53 ± 1.23 and glomerular filtration rate (GFR) level was 36.94 ± 45.08 mL/min. The factors associated with poor renal outcome were IFTA (P=0.01), phosphate level before discharge, serum creatinine level before and after discharge (P=0.032), and GFR level after discharge (P=0.001). Conclusion Crescentic glomerulonephritis is an important cause of acute kidney injury due to its potential to result in severe glomerular injury. In our study, 12 out of 17 patients experienced poor renal outcomes, which were associated with a high risk of morbidity and mortality. Therefore, early detection and treatment of CrGN is crucial in order to manage the disease.

The Clinicopathological Correlation and Outcome of Glomerulonephritis With Crescent: A Single-Center Study

“…Rapidly progressive glomerulonephritis (RPGN) is identified by a more than 50% decline in glomerular filtration rate (GFR) within three months, in kidney function, typically stemming from various conditions that lead to the development of crescent-shaped structures visible in renal biopsies. Consequently, it is also referred to as glomerulonephritis (GN) with crescent in pathological terminology [1,2]. RPGN is a very rare condition worldwide [3].…”

“…The incidence rate in the United States stands at about seven cases per one million persons per year, while the United Kingdom reports two cases per one million [4]. It necessitates early intervention to prevent progressive renal failure or death [1]. GN with crescent is one of the most common causes of morbidity and mortality due to irreversible kidney failure [5].…”

“…GN with crescent can be categorized into three distinct disease groups determined by the immunofluorescence microscopic pattern identified in kidney biopsy: linear, granular, and pauci-immune. A linear pattern indicates the presence of anti-glomerular basement membrane disease, while granular staining is characteristic of immune complex-mediated conditions, such as lupus nephritis and postinfectious GN [1]. Pauci-immune GN (pauciGN) is a constituent of systemic small vessel vasculitis, such as granulomatosis with polyangiitis [11].…”