Journal article
Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study
Journal of clinical medicine, Vol.9(8), p.2385
08/01/2020
DOI: 10.3390/jcm9082385
PMCID: PMC7464981
PMID: 32722612
Abstract
There is no evidence-based definition for diagnosing crescentic glomerulonephritis. The prognostic implications of crescentic lesions on kidney biopsy have not been quantified. Our objective was to determine risk factors for end-stage kidney disease (ESKD) in patients with glomerulonephritis and crescents on kidney biopsy. A query of the Pediatric Nephrology Research Consortium's Pediatric Glomerulonephritis with Crescents registry identified 305 patients from 15 centers. A retrospective cohort study was performed with ESKD as the primary outcome. Median age at biopsy was 11 years (range 1-21). The percentage of crescents was 3-100% (median 20%). Etiologies included IgA nephropathy (23%), lupus (21%), IgA vasculitis (19%) and ANCA-associated GN (13%), post-infectious GN (5%), and anti-glomerular basement membrane disease (3%). The prevalence of ESKD was 12% at one year and 16% at last follow-up (median = 3 years, range 1-11). Median time to ESKD was 100 days. Risk factors for ESKD included %crescents, presence of fibrous crescents, estimated GFR, and hypertension at biopsy. For each 1% increase in %crescents, there was a 3% decrease in log odds of 1-year renal survival (p= 0.003) and a 2% decrease in log odds of renal survival at last follow-up (p< 0.001). These findings provide an evidence base for enrollment criteria for crescentic glomerulonephritis in future clinical trials.
Details
- Title: Subtitle
- Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study
- Creators
- Joseph G. Maliakkal - Saint Louis UniversityM. John Hicks - Baylor College of MedicineMini Michael - Baylor College of MedicineDavid T. Selewski - Medical University of South CarolinaKatherine Twombley - Medical University of South CarolinaMichelle N. Rheault - University of MinnesotaMeredith Seamon - University of UtahJason M. Misurac - University of IowaCheryl L. Tran - Pediatric Nephrology, Mayo Clinic, Rochester, MN 55902, USA.Loretta Reyes - Emory UniversityJoseph T. Flynn - University of WashingtonAli M. Onder - University of MississippiAlexandru R. Constantinescu - Joe DiMaggio Children's HospitalVaishali Singh - Medical College of WisconsinCynthia Pan - Medical College of WisconsinAbiodun Omoloja - Wright State UniversityQiang Wu - East Carolina UniversityWilliam E. Smoyer - Nationwide Children's HospitalGuillermo Hidalgo - East Carolina UniversityScott E. Wenderfer - Baylor College of Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of clinical medicine, Vol.9(8), p.2385
- DOI
- 10.3390/jcm9082385
- PMID
- 32722612
- PMCID
- PMC7464981
- NLM abbreviation
- J Clin Med
- ISSN
- 2077-0383
- eISSN
- 2077-0383
- Publisher
- Mdpi
- Number of pages
- 13
- Grant note
- PNRC Department of Pediatrics at East Carolina University Brody School of Medicine
- Language
- English
- Date published
- 08/01/2020
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics
- Record Identifier
- 9984354037802771
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