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Clinico-Pathological Outcomes of Patients With Crescentic Glomerulonephritis: A Single-Center Study
Abdullah Z Alsuheili1, Hanadi Alhozali2, Ayar A Bukhari1
1Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU.
Insights
Crescentic glomerulonephritis (CrGN) often leads to severe kidney damage and poor outcomes. Early detection and treatment are vital for managing this condition and improving patient prognosis.
Area of Science:
- Nephrology
- Pathology
- Internal Medicine
Background:
- Crescentic glomerulonephritis (CrGN) is a severe form of rapidly progressive glomerulonephritis (RPGN) associated with significant renal failure and poor prognosis.
- Understanding the clinical outcomes of CrGN is crucial for effective patient management.
Purpose of the Study:
- To investigate the clinical outcomes of patients diagnosed with crescentic glomerulonephritis (CrGN) at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia.
Main Methods:
- A retrospective study analyzed data from 56 patients diagnosed with CrGN via renal biopsy between 2002 and 2015.
- Data from 17 CrGN cases were collected and analyzed, focusing on clinical and histological findings, laboratory results, and renal outcomes.
Main Results:
- The study identified cellular crescents (94.1%) and interstitial fibrosis and tubular atrophy (IFTA) (76.5%) as common histological findings.
- Lupus nephritis was the most frequent underlying etiology (41.2%).
- Factors associated with poor renal outcomes included IFTA, elevated serum creatinine, and lower GFR levels post-discharge.
Conclusions:
- Crescentic glomerulonephritis is a significant cause of acute kidney injury with a high potential for severe glomerular damage.
- A majority of patients (12 out of 17) experienced poor renal outcomes, highlighting the associated morbidity and mortality risks.
- Prompt diagnosis and timely intervention are essential for managing CrGN and improving patient outcomes.
Abstract:
Background Crescentic glomerulonephritis (CrGN) is a pathological description of rapidly progressive glomerulonephritis (RPGN). It is characterized by renal failure and is associated with a grave prognosis. This study aimed to investigate the clinical outcomes of patients diagnosed with crescentic glomerulonephritis at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Method This retrospective study included patients with CrGN who underwent treatment at the nephrology department at KAUH from June 2021 to August 2022. We collected and analyzed data from 56 patients diagnosed with CrGN on the basis of renal biopsies between 2002 and 2015. Result The study included 17 cases of CrGN. The mean age of patients at the time of diagnosis was 18.06 ± 13.49 years. The distribution of histological findings showed that cellular crescents (94.1%) and interstitial fibrosis and tubular atrophy (IFTA) (76.5%) were the most commonly observed histological findings. The most common underlying etiology was lupus nephritis (41.2%). Regarding the lab results, the mean serum creatinine level at admission was 378.88 ± 273.27 μmol/L, proteinuria was 1.53 ± 1.23 and glomerular filtration rate (GFR) level was 36.94 ± 45.08 mL/min. The factors associated with poor renal outcome were IFTA (P=0.01), phosphate level before discharge, serum creatinine level before and after discharge (P=0.032), and GFR level after discharge (P=0.001). Conclusion Crescentic glomerulonephritis is an important cause of acute kidney injury due to its potential to result in severe glomerular injury. In our study, 12 out of 17 patients experienced poor renal outcomes, which were associated with a high risk of morbidity and mortality. Therefore, early detection and treatment of CrGN is crucial in order to manage the disease.
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