Alsuheili Abdullah Z, Alhozali Hanadi, Bukhari Ayar A, Khan Mohammad A, Alzahrani Abdulaziz S, Abualnaja Suhail K, Al Zahrani Reem A
Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU.
Faculty of Medicine, Department of Medicine, Nephrology Unit, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2023 May 9;15(5):e38777. doi: 10.7759/cureus.38777. eCollection 2023 May.
Background Crescentic glomerulonephritis (CrGN) is a pathological description of rapidly progressive glomerulonephritis (RPGN). It is characterized by renal failure and is associated with a grave prognosis. This study aimed to investigate the clinical outcomes of patients diagnosed with crescentic glomerulonephritis at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Method This retrospective study included patients with CrGN who underwent treatment at the nephrology department at KAUH from June 2021 to August 2022. We collected and analyzed data from 56 patients diagnosed with CrGN on the basis of renal biopsies between 2002 and 2015. Result The study included 17 cases of CrGN. The mean age of patients at the time of diagnosis was 18.06 ± 13.49 years. The distribution of histological findings showed that cellular crescents (94.1%) and interstitial fibrosis and tubular atrophy (IFTA) (76.5%) were the most commonly observed histological findings. The most common underlying etiology was lupus nephritis (41.2%). Regarding the lab results, the mean serum creatinine level at admission was 378.88 ± 273.27 μmol/L, proteinuria was 1.53 ± 1.23 and glomerular filtration rate (GFR) level was 36.94 ± 45.08 mL/min. The factors associated with poor renal outcome were IFTA (P=0.01), phosphate level before discharge, serum creatinine level before and after discharge (P=0.032), and GFR level after discharge (P=0.001). Conclusion Crescentic glomerulonephritis is an important cause of acute kidney injury due to its potential to result in severe glomerular injury. In our study, 12 out of 17 patients experienced poor renal outcomes, which were associated with a high risk of morbidity and mortality. Therefore, early detection and treatment of CrGN is crucial in order to manage the disease.
背景 新月体性肾小球肾炎（CrGN）是快速进展性肾小球肾炎（RPGN）的一种病理学描述。其特征为肾衰竭，预后不良。本研究旨在调查沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院（KAUH）诊断为新月体性肾小球肾炎患者的临床结局。方法 这项回顾性研究纳入了2021年6月至2022年8月在KAUH肾内科接受治疗的CrGN患者。我们收集并分析了2002年至2015年间56例经肾活检诊断为CrGN患者的数据。结果 该研究纳入了17例CrGN患者。诊断时患者的平均年龄为18.06±13.49岁。组织学检查结果分布显示，细胞性新月体（94.1%）和间质纤维化及肾小管萎缩（IFTA）（76.5%）是最常见的组织学检查结果。最常见的潜在病因是狼疮性肾炎（41.2%）。关于实验室检查结果，入院时血清肌酐平均水平为378.88±273.27μmol/L，蛋白尿为1.53±1.23，肾小球滤过率（GFR）水平为36.94±45.08 mL/分钟。与不良肾脏结局相关的因素为IFTA（P=0.01）、出院前磷酸盐水平、出院前后血清肌酐水平（P=0.032）以及出院后GFR水平（P=0.001）。结论 新月体性肾小球肾炎因其导致严重肾小球损伤的可能性，是急性肾损伤的重要原因。在我们的研究中，17例患者中有12例出现不良肾脏结局，这与高发病率和死亡率风险相关。因此，CrGN的早期检测和治疗对于控制该疾病至关重要。
