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Glomerulonephritis with crescents among adult Saudi patients outcome and its predictors

N Oudah1, Z Al Duhailib, K Alsaad

  • 1King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Clinical and Experimental Medicine
|June 28, 2011
PubMed

Insights

This study on adult crescentic glomerulonephritis found lupus nephritis to be the most common cause, unlike previous reports. Prognosis was linked to glomeruli sclerosis and acute tubular necrosis, not initial kidney function.

Area of Science:

  • Nephrology
  • Pathology
  • Clinical Medicine

Background:

  • Crescentic glomerulonephritis (CrGN) is a severe kidney disease characterized by rapid glomerular damage.
  • Understanding the clinical and pathological features, etiological factors, and outcomes of CrGN is crucial for patient management.
  • Lupus nephritis (LN) is a significant cause of CrGN, particularly in younger adults.

Purpose of the Study:

  • To investigate the clinical and pathological features of adult patients with crescentic glomerulonephritis.
  • To determine the outcomes of CrGN, including renal function and need for dialysis.
  • To compare outcomes across different etiological groups of CrGN.

Main Methods:

  • Retrospective study of 72 adult patients with CrGN over a 9-year period (2001-2010).
  • Assessment of histological features, including glomeruli sclerosis and acute tubular necrosis (ATN).
  • Recording and comparison of renal function at baseline and end of follow-up, including serum creatinine and proteinuria.

Main Results:

  • Lupus nephritis (LN) was the most frequent cause (49.3%), followed by pauciimmune glomerulonephritis (PIGN) (26.5%).
  • Majority of patients (85.7%) presented with renal impairment.
  • Independent predictors of dialysis need were percent of sclerosed glomeruli and presence of ATN.

Conclusions:

  • Lupus nephritis is a predominant cause of CrGN in this adult cohort.
  • Pauciimmune glomerulonephritis patients were older and had a worse prognosis, potentially due to higher glomeruli sclerosis.
  • Prognosis is influenced by histological damage (sclerosis, ATN) rather than initial clinical parameters.

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