Post-infectious glomerulonephritis with crescents in adults

A retrospective study

Shashidhar Baikunje, Mahesha Vankalakunti, A. Nikith, A. Srivatsa, Suhan Alva, Janardhan Kamath

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Crescent formation generally reflects severe glomerular injury. There is sparse literature on post-infectious glomerulonephritis (PIGN) with crescents in adults. This retrospective study looked at nine such cases to see if there is a correlation between the severity of presentation, steroid treatment, histological severity and outcome. Methods Biopsy reports of all the adults who underwent kidney biopsy from February 2010 to June 2014 in a tertiary care hospital were screened and all the cases with the diagnosis of PIGN with crescents were selected. Clinical presentation, laboratory data, histology, treatment and outcome were analysed. Results Six patients had evidence of recent/current infection, but all except two were non-streptococcal. The mean creatinine was 360.67 μmol/L (range 70.72-770.85) and the mean estimated glomerular filtration rate (MDRD eGFR) was 30.28 mL/min/1.73 m2 (range 6.4-111.1) on presentation. All five patients who were treated with steroids had an excellent response. Among the four patients who did not receive steroids, two were left with significant renal impairment (mean MDRD eGFR 23.5 mL/min/1.73 m2) at a mean follow-up of 15.5 months (range 10-21). The mean percentage of glomeruli with crescents was 36.13% (range 11.76-100) and except in one, there was no tubular atrophy or interstitial fibrosis and none had glomerulosclerosis. None of the patients progressed to end-stage renal disease. Conclusion Non-streptococcal infections are more common precipitants. There was no correlation between histological and clinical severity. Patients treated with steroids had better renal outcomes.

Original languageEnglish
Pages (from-to)222-226
Number of pages5
JournalClinical Kidney Journal
Volume9
Issue number2
DOIs
Publication statusPublished - 01-04-2016
Externally publishedYes

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Glomerulonephritis
Retrospective Studies
Steroids
Kidney
Biopsy
Tertiary Healthcare
Infection
Glomerular Filtration Rate
Tertiary Care Centers
Chronic Kidney Failure
Atrophy
Creatinine
Histology
Fibrosis
Wounds and Injuries
Therapeutics

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Baikunje, S., Vankalakunti, M., Nikith, A., Srivatsa, A., Alva, S., & Kamath, J. (2016). Post-infectious glomerulonephritis with crescents in adults: A retrospective study. Clinical Kidney Journal, 9(2), 222-226. https://doi.org/10.1093/ckj/sfv147
Baikunje, Shashidhar ; Vankalakunti, Mahesha ; Nikith, A. ; Srivatsa, A. ; Alva, Suhan ; Kamath, Janardhan. / Post-infectious glomerulonephritis with crescents in adults : A retrospective study. In: Clinical Kidney Journal. 2016 ; Vol. 9, No. 2. pp. 222-226.
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Baikunje, S, Vankalakunti, M, Nikith, A, Srivatsa, A, Alva, S & Kamath, J 2016, 'Post-infectious glomerulonephritis with crescents in adults: A retrospective study', Clinical Kidney Journal, vol. 9, no. 2, pp. 222-226. https://doi.org/10.1093/ckj/sfv147

Post-infectious glomerulonephritis with crescents in adults : A retrospective study. / Baikunje, Shashidhar; Vankalakunti, Mahesha; Nikith, A.; Srivatsa, A.; Alva, Suhan; Kamath, Janardhan.

In: Clinical Kidney Journal, Vol. 9, No. 2, 01.04.2016, p. 222-226.

Research output: Contribution to journalArticle

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N2 - Background Crescent formation generally reflects severe glomerular injury. There is sparse literature on post-infectious glomerulonephritis (PIGN) with crescents in adults. This retrospective study looked at nine such cases to see if there is a correlation between the severity of presentation, steroid treatment, histological severity and outcome. Methods Biopsy reports of all the adults who underwent kidney biopsy from February 2010 to June 2014 in a tertiary care hospital were screened and all the cases with the diagnosis of PIGN with crescents were selected. Clinical presentation, laboratory data, histology, treatment and outcome were analysed. Results Six patients had evidence of recent/current infection, but all except two were non-streptococcal. The mean creatinine was 360.67 μmol/L (range 70.72-770.85) and the mean estimated glomerular filtration rate (MDRD eGFR) was 30.28 mL/min/1.73 m2 (range 6.4-111.1) on presentation. All five patients who were treated with steroids had an excellent response. Among the four patients who did not receive steroids, two were left with significant renal impairment (mean MDRD eGFR 23.5 mL/min/1.73 m2) at a mean follow-up of 15.5 months (range 10-21). The mean percentage of glomeruli with crescents was 36.13% (range 11.76-100) and except in one, there was no tubular atrophy or interstitial fibrosis and none had glomerulosclerosis. None of the patients progressed to end-stage renal disease. Conclusion Non-streptococcal infections are more common precipitants. There was no correlation between histological and clinical severity. Patients treated with steroids had better renal outcomes.

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Baikunje S, Vankalakunti M, Nikith A, Srivatsa A, Alva S, Kamath J. Post-infectious glomerulonephritis with crescents in adults: A retrospective study. Clinical Kidney Journal. 2016 Apr 1;9(2):222-226. https://doi.org/10.1093/ckj/sfv147