Comparative study of IgA nephropathy with and without crescents.
Glomerular crescents were analyzed as a prognostic factor in retrospectively reviewed data from 144 patients with biopsy-proven IgA nephropathy. Crescents were found in 26 (18%) patients, and detected in 2 to 100% of glomeruli in each specimen. In 5% of the patients more than 50% of the glomeruli were affected. Thirty patients with IgA nephropathy without crescents were studied as a control group. Mean age was 30.3 +/- 9.4 and 30.2 +/- 12.0 years for the patients with and without crescents, respectively, and males prevailed in both groups. The length of follow-up was 23.2 +/- 41.6 months for patients with crescents and 29.3 +/- 35.3 months for patients without crescents. Eighty percent of the patients with crescents were hypertensive, compared to 27% of the non-crescent control group (P < 0.05). Mean serum creatinine at the time of diagnosis was 3.9 +/- 2.9 and 1.9 +/- 2.1 mg/dl for the patients with and without crescents, respectively. Initial urinary protein excretion was higher in patients with crescents (4.6 +/- 3.5 vs 1.2 +/- 0.9 g/day; P < 0.05). At the end of follow-up 17 patients (77.3%) from the crescent group and 3 (11.1%) from the non-crescent group had end-stage renal disease (P < 0.0001). The presence of crescents was associated with higher levels of initial serum creatinine and urinary protein excretion, and a higher frequency of hypertension and progression to end-stage renal disease.
Bitencourt-Dias
C
C
Disciplina de Nefrologia, Hospital das Clínicas, Universidade de São Paulo, Brasil. cristianebitencourt@uol.com.br
Bahiense-Oliveira
M
M
Saldanha
L B
LB
Barros
R T
RT
Woronik
V
V
D015415:Biomarkers; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000150:complications / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000209:etiology; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D011379:Prognosis
D015415:Biomarkers; D003404:Creatinine