Clinicopathological and Prognostic Study in Patients with Crescentic Glomerulonephritis: A Thirteen Year Single Center Experience

Objectives: Various risk factors associated with crescentic glomerulonephritis (CGN) prognosis have been reported, but there is no definitive consensus for prognostic predictors of kidney outcome.We aimed to investigate the factors associated with developing end-stage kidney disease (ESKD) in CGN patients. Materials and Methods:Over 13 years, we retrospectively evaluated kidney biopsy results, clinical, and laboratory data of patients diagnosed with CGN at our center.The relationships between potential predictors and kidney outcomes were investigated. Results:We analyzed 91 patients diagnosed with CGN.The mean age was 46.4±17.4years, and 59% were male.Over a median follow-up of 17 months, 34 (37%) patients resulted in ESKD, and 12 (13%) patients died.Cox regression analysis showed that the serum creatinine level was above 3 mg/dL at the time of diagnosis, requirement for dialysis, presence of more than 24% globally sclerotic glomeruli on kidney biopsy, and >25% interstitial fibrosis and tubular atrophy (IFTA) score were found to be associated with ESKD.On multivariate analysis, need for dialysis [hazard ratio (HR): 2.4, 95% confidence interval (CI): 1.06-5.40,p=0.034], the serum creatinine level >3 mg/dL (HR: 2.92, 95% CI: 1.05-8.10,p=0.040), and IFTA score >25% (HR: 2.85, 95% CI: 1.31-6.20,p=0.008) were independent risk factors for the development of ESKD. Conclusion:Chronic changes in kidney biopsy and the severity of kidney function impairment provide helpful information for predicting kidney outcomes in patients with CGN.Early diagnosis and appropriate therapy are of the utmost importance to improve the prognosis of patients with CGN.