SAT-410 Clinicopathologic Features and Outcomes of Patients with Crescentic Glomerulonephritis with Renal Involvement: A Single-Center, 13-year Retrospective Study from Turkey

Erdogmus, Siyar; Sadioğlu, Rezzan Eren; Kumru, Gizem; Eyupoglu, Sahin; Kutlay, Sim; Keven, Kenan; Nergızoğlu, Gökhan; Ateş, Kenan; Ertürk, Şehsuvar; Duman, Neval; Şengül, Şule

doi:10.1016/j.ekir.2020.02.434

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“…They demonstrated that 10 patients died during follow up [ 2 ]. According to the research by Erdogmus et al, 14 patients (13.5%) died and 35 patients (34%) advanced to ESRD by the conclusion of the 30-month follow-up period [ 30 ]. Furthermore, Alsuheili et al reported similar findings [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological characteristics and predictors of outcome of rapidly progressive glomerulonephritis: a retrospective study

Mohamed,

Ibrahim,

Saleh

et al. 2024

BMC Nephrol

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Background Globally, there are regional and time-based variations in the prevalence, etiology, and prognosis of rapidly progressive glomerulonephritis (RPGN). Prognosis of RPGN is poor, with a higher risk of death and end stage renal disease (ESRD) even with immunosuppressive medications. In the Middle East and North Africa, the studies on this disease are very limited. Therefore, we determined the predictors of outcome of RPGN. Methods We retrospectively assessed 101 adult patients over age of 18, diagnosed with RPGN based on renal biopsy illustrating crescents in ≥ 50% of the glomeruli. Patients who had crescents in their renal biopsies that were < 50% and those who refused to consent to a renal biopsy were excluded. We categorized the patients into 3 groups based on immunohistochemistry; type I, type II and type III. Then, depending on renal loss, we divided them into ESRD and non-ESRD groups. The clinical history and physical examination were retrieved. Additionally, 24-hour urine protein, urine analysis, renal function tests, serum albumin, complete blood count, antinuclear antibodies, anti-double stranded DNA antibodies, ANCA antibodies and serum complement levels were checked. Each patient underwent a kidney biopsy for immunohistochemistry and light microscopy. The percentage of crescentic glomeruli, number of sclerosed glomeruli, tertiary lymphoid organ (TLO), neutrophil infiltration, endocapillary or mesangial hypercellularity, interstitial fibrosis with tubular atrophy (IFTA) were analyzed. Primary outcomes (remission, ESRD and mortality) and secondary outcomes were assessed. Results Type II was the most frequent cause of RPGN (47.5%), followed by type III (32.7%) and type I (19.8%). 32 patients (31.7%) died during follow up, whereas 60 patients (59.4%) developed ESRD. In 41 patients (40.6%), remission occurred. Oliguria, serum creatinine, and need for HD at presentation were significantly increased in ESRD group compared to non-ESRD group (P < 0.001 for each). Mesangial proliferation, IFTA, TLO formation, sclerotic glomeruli and fibrous crescents were also significantly increased in ESRD group in comparison to non-ESRD group (P < 0.001 for each). Glomerulosclerosis (P = 0.036), and IFTA (P = 0.008) were predictors of ESRD. Infections (P = 0.02), respiratory failure (P < 0.001), and heart failure (P = 0.004) were mortality risk factors. Conclusion Type II RPGN was the most common. Infection was the most frequent secondary outcome. Oliguria, glomerulosclerosis, the requirement for hemodialysis at presentation, IFTA and TLO formation were predictors of ESRD. Respiratory failure, heart failure and infections were significant predictors of mortality.

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Section: Discussionmentioning

confidence: 99%

“…According to Erdogmus et al‘s research, IFTA score of more than 25%, as well as a serum creatinine of 3.5 mg/dl or higher, were risk factors for ESRD. These factors were revealed by Cox regression study for renal survival [ 30 ]. In a study by Parry et al, risk factors for a poor renal outcome were examined using univariate regression.…”

Section: Discussionmentioning

confidence: 99%