Glomerulonephritis with Crescents in Children : Etiology and Predictors of Renal Outcome

الملخص EN

Objective.

To investigate the clinicopathological features and outcome of glomerulonephritis with crescents among Saudi children.

Method.

This is a retrospective study of cases of crescentic glomerulonephritis (CrGN) seen over a 9-year period.

Histological features and renal function were recorded.

Results.

Thirty-seven cases were enrolled.

The mean percent of glomeruli with crescents was 39% (±19).

Lupus nephritis (LN) was the commonest etiology (54.1%).

At presentation, the serum creatinine (SCr) was 218.2 (±174.3) umol/l, and 57.1% of the cases had nephrotic range proteinuria.

By the end of the observation period, SCr dropped to 81.0 (±67.7) umol/l (P=0.001).

Worsening renal function was associated with younger age (P=0.002), non-LN etiology (P=0.01), more crescents (P=0.019), and ATN (P=0.05).

At the end of the followup, more patients in the LN group were dialysis-free (P=0.017) and had improved renal function (0.01) than in the non-LN group.

Using multivariate analysis, the only independent factor found to predict need for dialysis or change in SCr level was percent of globally sclerosed glomeruli (P=0.034).

Conclusion.

LN is the main cause of CrGN in our cohort of children.

The LN group had less globally sclerorsed glomeruli and better renal prognosis than the non-LN group.