Clinicopathological characteristics and outcomes of patients with crescentic lupus nephritis

Kidney Int. 2009 Aug;76(3):307-17. doi: 10.1038/ki.2009.136. Epub 2009 Apr 29.

Abstract

There are few clinicopathologic and outcome data on patients with crescentic lupus nephritis, therefore, we determined factors of the disease by retrospectively reviewing the records of 327 patients diagnosed with lupus nephritis. Of these, 152 cases were regrouped as class IV-G, including 33 patients with crescentic glomerulonephritis. Significantly, all patients with crescentic glomerulonephritis had acute kidney injury as compared with only about a quarter of the patients without the disease. On pathological evaluation, activity scores, chronicity indexes, relapse rates, and the frequency of positive serum anti-neutrophil cytoplasmic antibody (ANCA) were each significantly higher, whereas complete remission rates and renal outcomes, over a mean follow-up of 4 years, were significantly poorer in patients with crescentic glomerulonephritis. Our study shows that crescentic glomerulonephritis was not rare in patients with lupus nephritis and that their long-term outcome was poor. The precise role of ANCA in the pathologic course of crescentic lupus nephritis remains to be determined.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • Asian Continental Ancestry Group
  • China
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney / pathology*
  • Lupus Nephritis / drug therapy
  • Lupus Nephritis / immunology
  • Lupus Nephritis / pathology*
  • Male
  • Middle Aged
  • Prednisone / therapeutic use
  • Remission Induction
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Glucocorticoids
  • Immunosuppressive Agents
  • Prednisone