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Updated: Dec 28, 2025

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Crescentic glomerulonephritis in children.

Ulrike Mayer1, Jessica Schmitz2, Jan Hinrich Bräsen2

  • 1Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.

Pediatric Nephrology (Berlin, Germany)
|February 14, 2020
PubMed
Summary
This summary is machine-generated.

Early diagnosis and aggressive treatment are crucial for managing pediatric crescentic glomerulonephritis (cGN). Cyclosporine A and mycophenolate mofetil show promise as effective alternatives for treating this kidney disease.

Keywords:
Acute kidney injuryChildrenDialysisGlomerulonephritisKidney biopsyPrednisolone

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Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Immunology

Background:

  • Crescentic glomerulonephritis (cGN) is a significant cause of acute kidney injury in children, yet knowledge regarding its nuances remains limited.
  • Understanding the diverse etiologies and clinical trajectories of pediatric cGN is essential for improving patient outcomes.

Purpose of the Study:

  • To investigate the underlying causes, clinical presentations, and treatment outcomes of pediatric crescentic glomerulonephritis.
  • To identify factors influencing treatment success and explore alternative therapeutic strategies.

Main Methods:

  • Retrospective analysis of kidney biopsy results, clinical data, and laboratory findings in 60 pediatric patients diagnosed with cGN over 16 years.
  • Evaluation of various treatment regimens, including corticosteroids, immunosuppressants (mycophenolate mofetil, cyclosporine A, cyclophosphamide, rituximab, azathioprine, tacrolimus), and plasmapheresis.

Main Results:

  • Immune complex glomerulonephritis (ICGN) was the most common underlying cause (75%), with IgA nephropathy being the most frequent subtype.
  • Patient outcomes varied based on the class of cGN, diagnostic delay, biopsy findings (crescent percentage, tubular atrophy, interstitial fibrosis, necrosis), and clinical factors like nephrotic syndrome and hypertension.
  • A significant proportion of patients required intensive immunosuppressive therapy, including multiple corticosteroid pulses and combination therapies.

Conclusions:

  • Successful treatment of pediatric cGN hinges on early diagnosis, prompt and aggressive therapeutic interventions, and consideration of the specific underlying pathology.
  • Cyclosporine A (CsA) and mycophenolate mofetil (MMF) demonstrate potential as effective therapeutic alternatives to cyclophosphamide in managing pediatric cGN.