A Hospital-Based Assessment of the Spectrum and Outcomes of Crescentic Glomerulonephritis: An Observational Study

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Abstract (English)

Abstract:
Aim: The aim of the present study was to identify the etiology, assess and compare the clinical features,
histomorphological parameters and outcomes of patients with Crescentic glomerulonephritis (CrGN).
Methods: This observational study was conducted in the Department of Nephrology, Patna Medical College
and Hospital, Patna, Bihar, India for a period of 2 years. Fifty biopsy proven crescentic glomerulonephritis
patients with variable presentation were analysed in this study. Crescentic glomerulonephritis was defined by
crescent formation over 50% sampled glomeruli in biopsy specimen.
Results: Immune-complex glomerulonephritis (ICGN) was the most common etiology (n = 40; 80%) followed
by pauci-immune glomerulonephritis (PauciGN; n = 8; 16%) and anti-glomerular basement membrane disease
(n = 2; 4%). The most common etiology of ICGN was IgA nephropathy (n = 13; 26%) followed by lupus
nephritis (n = 10; 20%) and post-infectious glomerulonephritis (PIGN) (n = 10; 20%).There was no difference in
the clinical, biochemical and histopathological parameters between these categories.
Conclusion: Immune-complex glomerulonephritis is the most common cause of CrGN in this part of the
country with IgA nephropathy being the predominant disease. The clinical presentation is marked by severe
renal failure at presentation and comparatively lesser response rates, higher mortality and progression to ESRD
in spite of strict adherence to standard immunosuppressive therapy.