Clinicopathological characteristics and outcomes of diffuse crescentic Glomerulonephritis - A single center experience from southern India

Shankar Prasad Nagaraju, Sindhura Lakshmi Koulmane Laxminarayana, Srinivas Kosuru, Rajeevalochana Parthasarathy, Ravindra Prabhu Attur, Dharshan Rangaswamy, Uday Venkat Matteti, Vasudeva Guddattu

Research output: Contribution to journalArticle

Abstract

Introduction: Diffuse Crescentic glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure and has grave prognosis. There is significant regional and temporal variation in aetiology, prevalence and prognosis of diffuse crescentic glomerulonephritis (CrGN) with limited data available in adult Indian population. Aim: This study aims to identify the aetiology, clinico-pathological features and outcomes of diffuse CrGN in south Indian population. Materials and Methods: In this retrospective study, clinical records of all adults (>18 years) over a 5-year period (2010-2014) with a histopathological diagnosis of diffuse CrGN (>50% crescents) were reviewed. Clinical, serological, biochemical and histopathological data were collected. Follow-up data at six months including renal outcome and mortality were studied. Data was analysed using SPSS version 15. Results: There were 29 cases of diffuse CrGN accounting for an incidence of 2.9% among 1016 non-transplant kidney biopsies. The most common cause was pauci-immune crescentic GN. The median creatinine at admission was 7.2 mg/dl {(interquartile range (IR) 3.3-10.4)} and 75.9% of patients required haemodialysis at admission. Complete/partial recovery was seen in 34.5%. At the end of six months 31% were dialysis dependent and the mortality was 27.6%. On univariate analysis, the significant predictors of renal loss and mortality were oliguria (p=0.02), requirement of haemodialysis and serum creatinine (p=0.001) at admission (>5.5mg/dl) (p=0.003). Histopathological features did not influence the outcome in our study. Conclusion: In our cohort, the most common cause for diffuse CrGN is pauci-immune CrGN. Diffuse CrGN carries a poor prognosis. Patients with pauci-immune and AntiGBM disease have worst prognosis compared to immune complex CrGN. The presence of oliguria, high serum creatinine and requirement of haemodialysis at admission are associated with poor outcomes.

Original languageEnglish
Pages (from-to)OC21-OC24
JournalJournal of Clinical and Diagnostic Research
Volume11
Issue number9
DOIs
Publication statusPublished - 01-09-2017

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Glomerulonephritis
India
Creatinine
Dialysis
Biopsy
Antigen-Antibody Complex
Oliguria
Renal Dialysis
Kidney
Recovery
Mortality
Immune System Diseases
Serum
Population
Renal Insufficiency
Retrospective Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

Nagaraju, Shankar Prasad ; Laxminarayana, Sindhura Lakshmi Koulmane ; Kosuru, Srinivas ; Parthasarathy, Rajeevalochana ; Attur, Ravindra Prabhu ; Rangaswamy, Dharshan ; Matteti, Uday Venkat ; Guddattu, Vasudeva. / Clinicopathological characteristics and outcomes of diffuse crescentic Glomerulonephritis - A single center experience from southern India. In: Journal of Clinical and Diagnostic Research. 2017 ; Vol. 11, No. 9. pp. OC21-OC24.
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abstract = "Introduction: Diffuse Crescentic glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure and has grave prognosis. There is significant regional and temporal variation in aetiology, prevalence and prognosis of diffuse crescentic glomerulonephritis (CrGN) with limited data available in adult Indian population. Aim: This study aims to identify the aetiology, clinico-pathological features and outcomes of diffuse CrGN in south Indian population. Materials and Methods: In this retrospective study, clinical records of all adults (>18 years) over a 5-year period (2010-2014) with a histopathological diagnosis of diffuse CrGN (>50{\%} crescents) were reviewed. Clinical, serological, biochemical and histopathological data were collected. Follow-up data at six months including renal outcome and mortality were studied. Data was analysed using SPSS version 15. Results: There were 29 cases of diffuse CrGN accounting for an incidence of 2.9{\%} among 1016 non-transplant kidney biopsies. The most common cause was pauci-immune crescentic GN. The median creatinine at admission was 7.2 mg/dl {(interquartile range (IR) 3.3-10.4)} and 75.9{\%} of patients required haemodialysis at admission. Complete/partial recovery was seen in 34.5{\%}. At the end of six months 31{\%} were dialysis dependent and the mortality was 27.6{\%}. On univariate analysis, the significant predictors of renal loss and mortality were oliguria (p=0.02), requirement of haemodialysis and serum creatinine (p=0.001) at admission (>5.5mg/dl) (p=0.003). Histopathological features did not influence the outcome in our study. Conclusion: In our cohort, the most common cause for diffuse CrGN is pauci-immune CrGN. Diffuse CrGN carries a poor prognosis. Patients with pauci-immune and AntiGBM disease have worst prognosis compared to immune complex CrGN. The presence of oliguria, high serum creatinine and requirement of haemodialysis at admission are associated with poor outcomes.",
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Clinicopathological characteristics and outcomes of diffuse crescentic Glomerulonephritis - A single center experience from southern India. / Nagaraju, Shankar Prasad; Laxminarayana, Sindhura Lakshmi Koulmane; Kosuru, Srinivas; Parthasarathy, Rajeevalochana; Attur, Ravindra Prabhu; Rangaswamy, Dharshan; Matteti, Uday Venkat; Guddattu, Vasudeva.

In: Journal of Clinical and Diagnostic Research, Vol. 11, No. 9, 01.09.2017, p. OC21-OC24.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinicopathological characteristics and outcomes of diffuse crescentic Glomerulonephritis - A single center experience from southern India

AU - Nagaraju, Shankar Prasad

AU - Laxminarayana, Sindhura Lakshmi Koulmane

AU - Kosuru, Srinivas

AU - Parthasarathy, Rajeevalochana

AU - Attur, Ravindra Prabhu

AU - Rangaswamy, Dharshan

AU - Matteti, Uday Venkat

AU - Guddattu, Vasudeva

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Introduction: Diffuse Crescentic glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure and has grave prognosis. There is significant regional and temporal variation in aetiology, prevalence and prognosis of diffuse crescentic glomerulonephritis (CrGN) with limited data available in adult Indian population. Aim: This study aims to identify the aetiology, clinico-pathological features and outcomes of diffuse CrGN in south Indian population. Materials and Methods: In this retrospective study, clinical records of all adults (>18 years) over a 5-year period (2010-2014) with a histopathological diagnosis of diffuse CrGN (>50% crescents) were reviewed. Clinical, serological, biochemical and histopathological data were collected. Follow-up data at six months including renal outcome and mortality were studied. Data was analysed using SPSS version 15. Results: There were 29 cases of diffuse CrGN accounting for an incidence of 2.9% among 1016 non-transplant kidney biopsies. The most common cause was pauci-immune crescentic GN. The median creatinine at admission was 7.2 mg/dl {(interquartile range (IR) 3.3-10.4)} and 75.9% of patients required haemodialysis at admission. Complete/partial recovery was seen in 34.5%. At the end of six months 31% were dialysis dependent and the mortality was 27.6%. On univariate analysis, the significant predictors of renal loss and mortality were oliguria (p=0.02), requirement of haemodialysis and serum creatinine (p=0.001) at admission (>5.5mg/dl) (p=0.003). Histopathological features did not influence the outcome in our study. Conclusion: In our cohort, the most common cause for diffuse CrGN is pauci-immune CrGN. Diffuse CrGN carries a poor prognosis. Patients with pauci-immune and AntiGBM disease have worst prognosis compared to immune complex CrGN. The presence of oliguria, high serum creatinine and requirement of haemodialysis at admission are associated with poor outcomes.

AB - Introduction: Diffuse Crescentic glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure and has grave prognosis. There is significant regional and temporal variation in aetiology, prevalence and prognosis of diffuse crescentic glomerulonephritis (CrGN) with limited data available in adult Indian population. Aim: This study aims to identify the aetiology, clinico-pathological features and outcomes of diffuse CrGN in south Indian population. Materials and Methods: In this retrospective study, clinical records of all adults (>18 years) over a 5-year period (2010-2014) with a histopathological diagnosis of diffuse CrGN (>50% crescents) were reviewed. Clinical, serological, biochemical and histopathological data were collected. Follow-up data at six months including renal outcome and mortality were studied. Data was analysed using SPSS version 15. Results: There were 29 cases of diffuse CrGN accounting for an incidence of 2.9% among 1016 non-transplant kidney biopsies. The most common cause was pauci-immune crescentic GN. The median creatinine at admission was 7.2 mg/dl {(interquartile range (IR) 3.3-10.4)} and 75.9% of patients required haemodialysis at admission. Complete/partial recovery was seen in 34.5%. At the end of six months 31% were dialysis dependent and the mortality was 27.6%. On univariate analysis, the significant predictors of renal loss and mortality were oliguria (p=0.02), requirement of haemodialysis and serum creatinine (p=0.001) at admission (>5.5mg/dl) (p=0.003). Histopathological features did not influence the outcome in our study. Conclusion: In our cohort, the most common cause for diffuse CrGN is pauci-immune CrGN. Diffuse CrGN carries a poor prognosis. Patients with pauci-immune and AntiGBM disease have worst prognosis compared to immune complex CrGN. The presence of oliguria, high serum creatinine and requirement of haemodialysis at admission are associated with poor outcomes.

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