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Glomerular Outgrowth as an Ex Vivo Assay to Analyze Pathways Involved in Parietal Epithelial Cell Activation
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Published on: August 19, 2020

Etiology and outcome of crescentic glomerulonephritis

Aditi Sinha1, Kriti Puri, Pankaj Hari

  • 1Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Indian Pediatrics
|October 2, 2012
PubMed

Insights

Pauci-immune crescentic glomerulonephritis (GN) is common in children and carries a higher risk of kidney damage. Early signs like oliguria and dialysis needs predict worse outcomes in pediatric crescentic GN.

Area of Science:

  • Pediatric Nephrology
  • Glomerular Diseases
  • Immunopathology

Background:

  • Crescentic glomerulonephritis (GN) is a severe kidney disease characterized by rapid glomerular damage.
  • Understanding the specific types, causes, and outcomes of crescentic GN in children is crucial for effective management.

Purpose of the Study:

  • To investigate the causes, disease progression, and outcome predictors in pediatric patients diagnosed with crescentic glomerulonephritis.
  • To classify crescentic GN based on immunofluorescence and serology and assess associated risk factors for renal failure.

Main Methods:

  • A retrospective descriptive study was conducted on children (<18 years) with crescentic GN diagnosed between 2001-2010.
  • Crescentic GN was defined as crescents in ≥50% of glomeruli; classification involved immunofluorescence and serology.
  • Risk factors for renal loss (CKD stages 4-5) were analyzed.

Main Results:

  • Out of 36 children, 17 had immune complex GN and 19 had pauci-immune crescentic GN.
  • Pauci-immune GN patients, often ANCA-negative, showed a trend towards poorer renal survival (54.1% at 8 years) compared to immune complex GN (75.3% at 8 years).
  • Oliguria at presentation and need for dialysis were significant predictors of renal loss, while a higher proportion of normal glomeruli was protective.

Conclusions:

  • Pauci-immune GN accounts for half of pediatric crescentic GN cases in this cohort, presenting a greater risk for disease progression.
  • Children with pauci-immune GN, particularly ANCA-negative cases, face a higher likelihood of experiencing renal loss.
  • The severity of the initial presentation and the extent of glomerular damage are key determinants of renal outcomes in pediatric crescentic GN.
Abstract

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