Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center
Background. The importance of crescent formation in glomerulonephritis has increased. However, detailed analysis of crescentic glomerulonephritis in Asia is scarce. In addition, advances in serological diagnostic techniques (antineutrophil cytoplasmic and antiglomerular basement membrane autoantibod...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2022/1749548 |
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| author | Tomo Nakakita Kenichi Akiyama Kazunori Karasawa Yoei Miyabe Takahito Moriyama Keiko Uchida Kosaku Nitta |
| author_facet | Tomo Nakakita Kenichi Akiyama Kazunori Karasawa Yoei Miyabe Takahito Moriyama Keiko Uchida Kosaku Nitta |
| author_sort | Tomo Nakakita |
| collection | DOAJ |
| description | Background. The importance of crescent formation in glomerulonephritis has increased. However, detailed analysis of crescentic glomerulonephritis in Asia is scarce. In addition, advances in serological diagnostic techniques (antineutrophil cytoplasmic and antiglomerular basement membrane autoantibodies) and early diagnosis have reduced the number of cases meeting the strict definition of crescentic glomerulonephritis (>50% of glomeruli are crescentic). Therefore, we analyzed the clinicopathological features and renal prognosis of glomerulonephritis cases that exhibited at least one crescentic lesion. Methods. We retrospectively evaluated 265 adult patients diagnosed with glomerulonephritis with at least one crescent formation based on the results of renal biopsy. We divided the patients into two groups based on the four types of glomerulonephritis, namely, the immune-complex (type II: IgA nephropathy, IgA vasculitis with nephritis, and lupus nephritis) and pauci-immune (type III: microscopic polyangiitis) groups. Factors affecting renal prognosis (end-stage renal failure requiring renal replacement therapy) were examined in a multivariate analysis using the Cox proportional hazards model. Kaplan–Meier curves and log-rank test were used to analyze and compare time from entry to renal death. Results. Renal prognosis differed significantly between the immune-complex and pauci-immune groups. Among the four types of glomerulonephritis, IgA nephropathy was the most prevalent. Multivariate analysis showed that renal function at renal biopsy and the ratio of global sclerosis independently predicted renal prognosis, but the type of glomerulonephritis was not a factor. Conclusions. Renal dysfunction at renal biopsy and the ratio of global sclerosis predicted renal prognosis, because it reflects the degree of irreversible renal damage. We also suspect that the formation of at least one crescentic lesion led to the development of these predictive factors, regardless of the type of glomerular disease and degree of crescent formation. |
| format | Article |
| id | doaj-art-1961127264b24198b6d61b06c9421384 |
| institution | Kabale University |
| issn | 2090-2158 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-1961127264b24198b6d61b06c94213842025-02-03T01:06:42ZengWileyInternational Journal of Nephrology2090-21582022-01-01202210.1155/2022/1749548Analysis of Various Types of Glomerulonephritis with Crescents at a Single CenterTomo Nakakita0Kenichi Akiyama1Kazunori Karasawa2Yoei Miyabe3Takahito Moriyama4Keiko Uchida5Kosaku Nitta6Department of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyBackground. The importance of crescent formation in glomerulonephritis has increased. However, detailed analysis of crescentic glomerulonephritis in Asia is scarce. In addition, advances in serological diagnostic techniques (antineutrophil cytoplasmic and antiglomerular basement membrane autoantibodies) and early diagnosis have reduced the number of cases meeting the strict definition of crescentic glomerulonephritis (>50% of glomeruli are crescentic). Therefore, we analyzed the clinicopathological features and renal prognosis of glomerulonephritis cases that exhibited at least one crescentic lesion. Methods. We retrospectively evaluated 265 adult patients diagnosed with glomerulonephritis with at least one crescent formation based on the results of renal biopsy. We divided the patients into two groups based on the four types of glomerulonephritis, namely, the immune-complex (type II: IgA nephropathy, IgA vasculitis with nephritis, and lupus nephritis) and pauci-immune (type III: microscopic polyangiitis) groups. Factors affecting renal prognosis (end-stage renal failure requiring renal replacement therapy) were examined in a multivariate analysis using the Cox proportional hazards model. Kaplan–Meier curves and log-rank test were used to analyze and compare time from entry to renal death. Results. Renal prognosis differed significantly between the immune-complex and pauci-immune groups. Among the four types of glomerulonephritis, IgA nephropathy was the most prevalent. Multivariate analysis showed that renal function at renal biopsy and the ratio of global sclerosis independently predicted renal prognosis, but the type of glomerulonephritis was not a factor. Conclusions. Renal dysfunction at renal biopsy and the ratio of global sclerosis predicted renal prognosis, because it reflects the degree of irreversible renal damage. We also suspect that the formation of at least one crescentic lesion led to the development of these predictive factors, regardless of the type of glomerular disease and degree of crescent formation.http://dx.doi.org/10.1155/2022/1749548 |
| spellingShingle | Tomo Nakakita Kenichi Akiyama Kazunori Karasawa Yoei Miyabe Takahito Moriyama Keiko Uchida Kosaku Nitta Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center International Journal of Nephrology |
| title | Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center |
| title_full | Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center |
| title_fullStr | Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center |
| title_full_unstemmed | Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center |
| title_short | Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center |
| title_sort | analysis of various types of glomerulonephritis with crescents at a single center |
| url | http://dx.doi.org/10.1155/2022/1749548 |
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