Etiology and frequency distribution of crescentic glomerulonephritis in renal biopsy

Abstract

Background: Crescentic glomerulonephritis results from proliferating cells in Bowman's capsule and formation of crescents. It is classified in three major groups: Anti-Glomerular basement membrane (anti GBM) antibody mediated, Immune-complex mediated, and antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis. Methods: This is a cross-sectional study of 87 biopsy-proven cases of crescentic glomerulonephritis during 2011-2015 in a single center. They were classified into six groups: Lupus nephritis, Immunoglobulin A (IgA) nephropathy, ANCA-associated glomerulonephritis (containing of cANCA and pANCA vasculitis), Goodpasture syndrome, Cryoglobulinemia, and Poststreptococcal glomerulonephritis (PSGN). Findings: Of 87 renal biopsy, 62 were males. The mean age in all patients groups was 36 � 17 years. Frequency distribution of the groups in our study were as follow: IgA nephropathy (41.3), Lupus nephritis (36.7), ANCA-associated glomerulonephritis (16), Goodpasture syndrome (2.2), Cryoglobulinemia (2.2), and PSGN (1.1). Mean and median of serum creatinine and proteinuria were 2 � 1 mg/dl (Median = 1mg/dl) and 1930 � 830 mg/day (Median = 2000mg/day). In this study, we found a significant positive correlation between the number of crescents and age (P < 0.001), additionally we found a positive association between the proportion of crescents and serum creatinine (P = 0.007), however, there were no significant correlation between the proportion of crescents and proteinuria (P > 0.050). Conclusion: This study reveals the importance of relationship between the proportion of crescents and serum creatinine.Therefore the proportion of crescents may influence the prognosis of the disease. This research approved most prevalence reason for crescentic glomerulonephritis was IgA nephropathy. This study shows the role of renal biopsy in early diagnosis of crescentic glomerulonephritis while this study showed the positive correlation between crescents and serum creatinine. � 2016, Journal of Isfahan Medical School. All rights reserved.