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Updated: Jan 25, 2026
Assessment of Kidney Function in Mouse Models of Glomerular Disease
Published on: June 30, 2018
Prognostic factors in glomerular diseases with crescents
Hasan Haci Yeter1, Ipek Gonul2, Ertugrul Demirel3
1Department of Nephrology, Gazi University, Ankara, Turkey.
Insights
Kidney biopsy crescent percentage impacts survival. Over 34% crescents and high creatinine indicate aggressive disease, requiring prompt treatment for better renal survival.
Area of Science:
- Nephrology
- Glomerular Diseases
- Renal Pathology
Background:
- Crescentic glomerulonephritis diagnosis requires >50% glomerular crescents.
- Standard treatments are lacking for patients with fewer than 50% crescents.
- Investigating crescent percentage and clinical factors for renal survival is crucial.
Purpose of the Study:
- To evaluate the impact of crescent percentage on renal survival.
- To identify clinical features associated with end-stage renal disease (ESRD).
- To determine factors affecting renal survival independent of underlying glomerulonephritis etiology.
Main Methods:
- Retrospective observational study of 49 patients with crescent formation.
- Analysis of clinicopathological features and renal survival.
- Evaluation of factors predicting progression to ESRD.
Main Results:
- 39% of patients progressed to ESRD.
- Factors associated with ESRD included: need for renal replacement therapy, creatinine >2.7 mg/dL, >50% glomerulosclerosis, and >34% crescent formation.
- Lower crescent percentage (<34%) and creatinine (<2.7 mg/dL) correlated with increased kidney survival.
Conclusions:
- Patients with >34% crescent formation require aggressive treatment evaluation.
- High serum creatinine (>2.7 mg/dL) alongside crescents warrants aggressive management.
- These factors are important for guiding treatment decisions regardless of the specific underlying disease.
Introduction:
More than 50% of glomerular crescent formation is required for a diagnosis of crescentic glomerulonephritis in a kidney biopsy. Although treatment protocols have been established for diffuse crescentic glomerulonephritis, there is no standard treatment for patients with fewer crescents in renal biopsies. In this study the importance of crescent percentage and clinical features on renal survival independent of underlying disease was investigated.
Methods:
This retrospective observational study was conducted between 2013 and 2017. Forty-nine patients with crescent formation in their kidney biopsies were evaluated. We compared clinicopathological features and renal survival. We evaluated the factors affecting the course of end stage renal disease (ESRD).
Results:
A total of 49 patients (57% male and median age 49 years) were enrolled in this study. 39% of patients developed ESRD at follow-up. Logistic regression analysis showed that the requirement for renal replacement treatment on admission (p < 0.001), serum creatinine level above 2.7 mg/dL (p < 0.001), the presence of more than 50% glomerulosclerosis (p = 0.04) and more than 34% crescent formation (p = 0.002) were significantly associated with ESRD. Kaplan-Meier survival analysis revealed that patients with less than 34% crescent in kidney biopsy and a serum creatinine level less than 2.7 mg/dL had increased kidney survival (log-rank test p: 0.01 and p: 0.002).
Conclusion:
Patients with crescent formation in kidney biopsy more than 34% should be evaluated for more aggressive treatment modalities regardless of the underlying disease, especially if the serum creatinine level is above 2.7 mg/dL.
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