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Prognostic analysis of crescentic glomerulonephritis with acute kidney injury: a single-center cohort with 5-year follow-up

  • Nephrology - Original Paper
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Abstract

Background

Crescentic glomerulonephritis (CrGN) represents a severe form of glomerular injury that results in high rates of renal failure. This study aimed to investigate the influence of potential clinical and pathological factors on renal outcomes of CrGN; and the relationship between 3-month and 5-year follow-up as well.

Methods

The cohort enrolled patients diagnosed of biopsy proven CrGN with acute kidney injury(AKI) from January 1, 2010, to January 1, 2018 in Shanghai Changzheng Hospital and followed up for 5 years.

Results

A total of 56 patients were included, among whom 11 patients (19.6%) had type I, 12 (21.4%) had type II, and 33 (58.9%) had type III CrGN. Patients with type II CrGN tended to have a lower crescent score, less renal tubular damage, and lower serum creatinine than the other two types. Three-month cumulative renal survival rates of types I, II, and III CrGN were 45.5%, 66.7%, and 48.5%, respectively. Five-year cumulative renal survival rates of types I, II, and III CrGN were 27.2%, 83.3%, and 36.4%, respectively. The Kappa Consistency Test between 3-month and 5-year outcomes was 0.573(P < 0.001). Cox regression model showed that in-hospital dialysis was an indicative renal survival factor in 3 months (HR 15.670, 95% CI 2.987–82.210, P = 0.001). It also showed that the crescent score had an unfavorable effect for renal survival in 5 years (HR 1.750 95% CI 1.018–3.009, P = 0.043).

Conclusions

Clinical manifestations and outcomes varied by different CrGN types. Three-month outcomes could partially reflect the 5-year outcomes. Severity of crescents was an independent risk factor for renal survival in CrGN.

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Acknowledgements

CZW, XJ, WJ, RMN, and XC provided substantial contributions to the conception or design of the work or to the acquisition, analysis or interpretation of data for the work. XJ, XC, and MCL drafted the work or revised it critically for important intellectual content. MZG approved the final version to be published. XJ and MZG were accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved.

Funding

Z Mao is a Fellow of the International Society of Nephrology. This work was funded by the National Natural Science Foundation of China (No. 82070705, and 81770670).

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Author notes

  1. Zewei Chen, Jing Xu, and Jun Wu share the first-author position.

Authors and Affiliations

  1. Division of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China

    Zewei Chen, Jing Xu, Jun Wu, Cheng Xue, Mengna Ruan, Changlin Mei & Zhiguo Mao

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  1. Zewei Chen
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  2. Jing Xu
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  3. Jun Wu
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Correspondence to Zhiguo Mao.

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Chen, Z., Xu, J., Wu, J. et al. Prognostic analysis of crescentic glomerulonephritis with acute kidney injury: a single-center cohort with 5-year follow-up. Int Urol Nephrol 54, 2375–2383 (2022). https://doi.org/10.1007/s11255-022-03111-w

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