Purpose: Crescentic glomerulonephritis (GN) is a rapidly progressive kidney disease associated with a high risk of end-stage renal disease (ESRD). This study aimed to assess whether systemic inflammation and nutritional status, as measured by the systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) at diagnosis, can predict one-year renal survival in patients with crescentic GN. Methods: This retrospective study included 82 adult patients with biopsy-proven Type 1 or Type 3 crescentic GN. Baseline SII and PNI were calculated from pre-treatment blood samples. Clinical, laboratory, and histopathological data were collected. Patients were followed for 12 months and classified into two groups based on the development of ESRD. Results: The cohort (63.4% male) had a mean age of 53.65 ± 15.87 years; 26 patients (31.7%) progressed to ESRD. Multivariate analysis identified elevated SII OR: 1.79; 95% CI: 1.22– 18.81; p = 0.03, low PNI OR: 0.92, 95% CI: 0.96– 0.99; p = 0.03, hypoalbuminemia OR: 0.36, 95% CI: 0.15– 0.84; p = 0.02, reduced estimated glomerular filtration rate OR: 0.93, 95% CI: 0.88– 0.98; p = 0.009, anemia OR: 0.37; 95% CI: 0.22– 0.63; p < 0.001, higher crescent ratio OR: 1.05, 95% CI: 1.02– 1.09; p = 0.02, and plasmapheresis requirement OR: 0.074, 95% CI: 0.016– 0.349; p = 0.001 as independent predictors of ESRD. Receiver operating characteristic analysis determined cutoff values of 176.38 for SII (area under the curve AUC: 0.679, p = 0.01) and 31.88 for PNI (AUC: 0.650, p = 0.03). Glomerulosclerosis ratio and interstitial fibrosis/tubular atrophy were not independently associated with ESRD (p = 0.13 and p = 0.14, respectively). Conclusion: SII and PNI are independent but moderate predictors of one-year renal survival in crescentic GN. Incorporating these readily available biomarkers with histological evaluation may enhance risk stratification and help guide early, aggressive immunosuppressive therapy. Keywords: crescentic glomerulonephritis, systemic immune-inflammation index, prognostic nutritional index, end-stage renal disease
Şahin et al. (Sun,) studied this question.