Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western China

Abstract Background The factors influencing diffuse crescentic glomerulonephritis renal survival and prognosis remain uncertain. Additionally, there’s no literature on the clinical outcomes of IgA nephropathy, lupus nephritis, and IgA vasculitis nephritis in type II patients. Methods This study retr...

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Main Authors: Shan Wen, Shasha Chen, Yingying Lin, Guisen Li, Ping Zhang, Wei Wang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-024-03923-1
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author Shan Wen
Shasha Chen
Yingying Lin
Guisen Li
Ping Zhang
Wei Wang
author_facet Shan Wen
Shasha Chen
Yingying Lin
Guisen Li
Ping Zhang
Wei Wang
author_sort Shan Wen
collection DOAJ
description Abstract Background The factors influencing diffuse crescentic glomerulonephritis renal survival and prognosis remain uncertain. Additionally, there’s no literature on the clinical outcomes of IgA nephropathy, lupus nephritis, and IgA vasculitis nephritis in type II patients. Methods This study retrospectively examined 107 patients diagnosed with diffuse crescentic glomerulonephritis through biopsy. Analytical methods included Cox regression models and Kaplan-Meier survival analysis to assess the data. Results Among the 107 enrolled patients, 12 patients had Type I diffuse crescentic glomerulonephritis, 70 patients had Type II, and 25 patients had Type III. The respective 5-year kidney survival rates were 0%, 57.5%, and 18.6% for type I, type II, and type III. Furthermore, among Type II patients, IgA nephropathy emerged as the most prevalent condition. The cumulative 5-year kidney survival rates were 50% for patients with IgA nephropathy, 64% for lupus nephritis, and 70% for Henoch-Schönlein purpura nephritis. A significant association between the risk of ESKD development and several factors was revealed by a multivariate Cox regression analysis: estimated glomerular filtration rate (P = 0.004), initial kidney replacement therapy (KRT) at presentation (P = 0.002), global glomerulosclerosis (P<0.001). Conclusions Type II diffuse crescentic glomerulonephritis was the most prevalent type in DCGN, and favors better renal prognosis than type I and III DCGN, in which IgA nephropathy was the most common entity of Type II DCGN. Additionally, estimated glomerular filtration rate, initial KRT at presentation and global glomerulosclerosis were identified as predictors of renal outcomes in diffuse crescentic glomerulonephritis.
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spelling doaj-art-0c9152012308457987bed09e074a5ec32025-01-19T12:13:37ZengBMCBMC Nephrology1471-23692025-01-0126111010.1186/s12882-024-03923-1Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western ChinaShan Wen0Shasha Chen1Yingying Lin2Guisen Li3Ping Zhang4Wei Wang5Renal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaRenal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaRenal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaRenal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaRenal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaRenal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaAbstract Background The factors influencing diffuse crescentic glomerulonephritis renal survival and prognosis remain uncertain. Additionally, there’s no literature on the clinical outcomes of IgA nephropathy, lupus nephritis, and IgA vasculitis nephritis in type II patients. Methods This study retrospectively examined 107 patients diagnosed with diffuse crescentic glomerulonephritis through biopsy. Analytical methods included Cox regression models and Kaplan-Meier survival analysis to assess the data. Results Among the 107 enrolled patients, 12 patients had Type I diffuse crescentic glomerulonephritis, 70 patients had Type II, and 25 patients had Type III. The respective 5-year kidney survival rates were 0%, 57.5%, and 18.6% for type I, type II, and type III. Furthermore, among Type II patients, IgA nephropathy emerged as the most prevalent condition. The cumulative 5-year kidney survival rates were 50% for patients with IgA nephropathy, 64% for lupus nephritis, and 70% for Henoch-Schönlein purpura nephritis. A significant association between the risk of ESKD development and several factors was revealed by a multivariate Cox regression analysis: estimated glomerular filtration rate (P = 0.004), initial kidney replacement therapy (KRT) at presentation (P = 0.002), global glomerulosclerosis (P<0.001). Conclusions Type II diffuse crescentic glomerulonephritis was the most prevalent type in DCGN, and favors better renal prognosis than type I and III DCGN, in which IgA nephropathy was the most common entity of Type II DCGN. Additionally, estimated glomerular filtration rate, initial KRT at presentation and global glomerulosclerosis were identified as predictors of renal outcomes in diffuse crescentic glomerulonephritis.https://doi.org/10.1186/s12882-024-03923-1Crescentic glomerulonephritisEnd stage kidney diseasePrognosisRisk factors
spellingShingle Shan Wen
Shasha Chen
Yingying Lin
Guisen Li
Ping Zhang
Wei Wang
Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western China
BMC Nephrology
Crescentic glomerulonephritis
End stage kidney disease
Prognosis
Risk factors
title Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western China
title_full Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western China
title_fullStr Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western China
title_full_unstemmed Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western China
title_short Clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis : a retrospective single-center study from Western China
title_sort clinicopathological characteristics and predictors of renal outcomes in diffuse crescentic glomerulonephritis a retrospective single center study from western china
topic Crescentic glomerulonephritis
End stage kidney disease
Prognosis
Risk factors
url https://doi.org/10.1186/s12882-024-03923-1
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