Etiology and Outcome of Crescentic Glomerulonephritis.
dc.contributor.author | Sinha, Aditi | |
dc.contributor.author | Puri, Kriti | |
dc.contributor.author | Hari, Pankaj | |
dc.contributor.author | Dinda, Amit Kumar | |
dc.contributor.author | Bagga, Arvind | |
dc.date.accessioned | 2016-01-04T10:51:09Z | |
dc.date.available | 2016-01-04T10:51:09Z | |
dc.date.issued | 2013-03 | |
dc.description.abstract | Objective: To determine the etiology, course and predictors of outcome in children with crescentic glomerulonephritis (GN). Study design: Retrospective, descriptive study. Setting: Pediatric Nephrology Clinic at a referral center in Northern India. Methods: Clinic records of patients aged <18 year with crescentic GN diagnosed from 2001-2010 and followed at least 12-months were reviewed. Crescentic GN, defined as crescents in ≥50% glomeruli, was classified based on immunofluorescence findings and serology. Risk factors for renal loss (chronic kidney disease stage 4-5) were determined. Results: Of 36 patients, (median age 10 yr) 17 had immune complex GN and 19 had pauci-immune crescentic GN. The etiologies of the former were lupus nephritis (n=4), postinfectious GN (3), and IgA nephropathy, Henoch Schonlein purpura and membranoproliferative GN type II (2 each). Three patients with pauci-immune GN showed antineutrophil cytoplasmic antibodies (ANCA). Rapidly progressive GN was present in 33 patients, and required dialysis in 12. At median 34 (19-72) months, 2 patients with immune complex GN and 8 with pauci-immune GN showed renal loss. Renal survival was 94.1% at 3 yr, and 75.3% at 8 yr in immune complex GN; in pauci-immune GN survival was 63.2% and 54.1%, respectively (P=0.054). Risk factors for renal loss were oliguria at presentation (hazards ratio, HR 10.50; P=0.037) and need for dialysis (HR 6.33; P=0.024); there was inverse association with proportion of normal glomeruli (HR 0.91; P=0.042). Conclusions: Pauci-immune GN constitutes one-half of patients with crescentic GN at this center. Patients with pauci-immune GN, chiefly ANCA negative, show higher risk of disease progression. Renal loss is related to severity of initial presentation and extent of glomerular involvement. | en_US |
dc.identifier.citation | Sinha Aditi, Puri Kriti, Hari Pankaj, Dinda Amit Kumar, Bagga Arvind. Etiology and Outcome of Crescentic Glomerulonephritis. Indian Pediatrics. 2013 March; 50(3): 283-288. | en_US |
dc.identifier.uri | https://imsear.searo.who.int/handle/123456789/169716 | |
dc.language.iso | en | en_US |
dc.source.uri | https://www.indianpediatrics.net/mar2013/mar-283-288.htm | en_US |
dc.subject | Antineutrophil cytoplasmic antibody | en_US |
dc.subject | Rapidly progressive glomerulonephritis | en_US |
dc.subject | Vasculitis | en_US |
dc.title | Etiology and Outcome of Crescentic Glomerulonephritis. | en_US |
dc.type | Article | en_US |