Comparative study of IgA nephropathy with and without crescents

Abstract

Glomerular crescents were analyzed as a prognostic factor in retrospectively reviewed data from 144 patients with biopsy-proven IgA nephropathy. Crescents were found in 26 (18%) patients, and detected in 2 to 100% of glomeruli in each specimen. In 5% of the patients more than 50% of the glomeruli were affected. Thirty patients with IgA nephropathy without crescents were studied as a control group. Mean age was 30.3 ± 9.4 and 30.2 ± 12.0 years for the patients with and without crescents, respectively, and males prevailed in both groups. The length of follow-up was 23.2 ± 41.6 months for patients with crescents and 29.3 ± 35.3 months for patients without crescents. Eighty percent of the patients with crescents were hypertensive, compared to 27% of the non-crescent control group (P < 0.05). Mean serum creatinine at the time of diagnosis was 3.9 ± 2.9 and 1.9 ± 2.1 mg/dl for the patients with and without crescents, respectively. Initial urinary protein excretion was higher in patients with crescents (4.6 ± 3.5 vs 1.2 ± 0.9 g/day; P < 0.05). At the end of follow-up 17 patients (77.3%) from the crescent group and 3 (11.1%) from the non-crescent group had end-stage renal disease (P < 0.0001). The presence of crescents was associated with higher levels of initial serum creatinine and urinary protein excretion, and a higher frequency of hypertension and progression to end-stage renal disease.

Oxford-MEST classification in IgAnephropathy patinets: A report from Iran

“…Crescents were found in 18% of their patients. They concluded that the presence of crescents was associated with higher levels of initial serum creatinine and urinary protein excretion and a higher frequency of hypertension and progression to end-stage renal disease (42). Simiraly we found a significant correlation between serum Cr and total crescents.…”

Predicting Post-Transplant Recurrence of IgA Nephropathy: The Importance of Crescents

“…Clinically, patients with crescentic IgAN have a higher incidence of hypertension and nephrotic syndrome 24,25 . In IgAN, crescents are associated with decreased renal survival, with an inverse correlation between the number of crescents and duration of renal survival 26,27 .…”

Clinical implication of crescentic lesions in immunoglobulin A nephropathy

“…Interestingly, a rapidly progressive course with crescentic formation is a rare clinical manifestation of IgAN, accounting for <5% of the whole population [12,13]. Crescents have been reported to be associated with a poor prognosis, and patients with such lesions often require intensive immunosuppressive treatments [14][15][16][17][18][19][20][21][22]. Of note, the Working Group of the Oxford classification excluded patients with rapidly progressive disease and an initial estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 .…”