Clinical Profile and Patient Outcomes of Crescentic Glomerulonephritis: A Descriptive Study in a Tertiary Care Hospital
Journal Title: Urology, Nephrology and Andrology International - Year 2018, Vol 3, Issue 2
Abstract
Background: Crescentic glomerulonephritis (CSGN) requires early intervention which can make a significant impact on minimizing irreversible kidney damage and improving patient outcomes Data regarding the clinical and histopathologic spectrum of CSGN among the Indian adult population is sparse. Objective: To study the etiology, clinicopathological features, prognostic factors and outcome of CSGN in Indian population. Method: This prospective, descriptive study was carried out in the Department of Nephrology, St John’s Medical College Hospital, Bengaluru which is a large territory care hospital in South India from July 2015 to October 2017. 37 patients diagnosed as CSGN on renal biopsy were studied. Results: The mean age of presentation in our study was 38.8 ± 13.7 years. The most common clinical presentation was in the form of rapidly progressive renal failure (54.1%). The most common etiological diagnosis was immune complex mediated glomerulonephritis (64.8%), followed second by pauci-immune GN (27%). Among immune complex group, IgA nephropathy was the leading cause (32.4%) and had the worst prognosis. The serum creatinine at presentation was an important prognostic marker with value of more than 5 mg/dl having poor outcome with 75% reaching end stage renal disease. Almost half of patients (50%) requiring renal replacement therapy at presentation reached end stage renal disease (ESRD). Conclusion: Crescentic GNs most commonly seen between third to fifth decades of life. Immune-complex glomerulonephritis (IgA nephropathy being the predominant disease) is the most common etiology of CSGN followed by anti-neutrophil cytoplasmic antibody positive pauci-immune GN. The predominant factors influencing renal outcomes were the extent of renal failure at presentation, need for renal replacement therapy at presentation and renal histology. Early diagnosis and therapy may facilitate favourable renal and patient outcomes.
Authors and Affiliations
Prashant G Kedlaya
Keywords
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- EP ID EP584572
- DOI 10.21088/unai.2456-5016.3218.2
- Views 76
- Downloads 0
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