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[Clinical features and prognosis of IgA nephropathy with glomerular crescents]
Xia Wan1, Jing-gao Li, Jie Bai
1Department of Nephrology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, China.
Objective:
To understand the clinical features and prognosis of IgA nephropathy (IgAN) patients with glomerular crescents.
Methods:
The clinical data collected at the time of renal biopsy and the follow-up data of 89 IgAN patients with glomerular crescents were analyzed with 412 IgAN patients without crescents serving as the control group. Follow-up study was conducted in 78 patients with crescents and 198 without it, and the renal survival rate was estimated using Kaplan-Meier survival analysis.
Results:
The incidence of glomerular crescents was 17.8% in IgAN patients. Clinically, 39 patients with crescents experienced rapidly progressive glomerulonephritis, resulting in a significantly higher rate of this manifestation than that in patients without crescent. Patients with crescents also had more grave pathological changes in the glomerulus and renal tubule interstitium than the control patients. Patients were followed up for an average of 40.3-/+29.6 months in crescent group and 45.1-/+26.9 months in the control group, and the 1-, 3-, 5-year renal survival rate was 95.24%, 80.95%, 61.9% in the former and 100%, 91.67%, 79.17% in the latter, respectively.
Conclusion:
IgAN patients with crescents have severer clinical and pathological manifestations and poorer prognosis than those without crescents.
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