title: Etiology and Outcome of Crescentic Glomerulonephritis From a Single Center in China: A 10-Year Review.
abstract: BACKGROUND
  The disease spectrum of crescentic glomerulonephritis (GN) has been described in only a few previous studies, and detailed epidemiologic data from China are unavailable to date.
  
  
  METHODS
  Case series.
  
  
  METHODS
  528 patients with biopsy-proven crescentic GN in 2003 to 2013 from a single center.
  
  
  METHODS
  Crescentic GN was classified into 3 types according to immunofluorescence findings: type I was defined as linear deposition of immunoglobulins along the glomerular basement membrane; type II, as glomerular deposition of immune complex; and type III, as pauci-immune deposition.
  
  
  RESULTS
  Demographic, clinical, and serologic characteristics.
  
  
  RESULTS
  Of 528 cases identified, 208 (39.4%) were men, with a mean age of 37.6±16.4 (SD) years at kidney biopsy. 61 (11.6%) patients had type I crescentic GN, 331 (62.7%) had type II (lupus nephritis, 34.3%; immunoglobulin A [IgA] nephropathy, 17.4%), and 136 (25.8%) had type III. Proportions of patients with acute kidney injury (AKI), acute kidney diseases and disorders without AKI, and chronic kidney disease were 86.9%, 0%, and 13.1% for type I; 42.0%, 19.6%, and 38.4% for type II; and 84.6%, 2.9%, and 12.5% for type III crescentic GN, respectively. Serum antineutrophil cytoplasmic antibodies were detected in 11 (18.0%) patients with type I, 15 (4.5%) with type II, and 117 (86.0%) with type III. Anti-glomerular basement membrane antibodies were found in 60 (98.4%) patients with type I, 3 (0.9%) with type II, and 5 (3.7%) with type III. 5-year cumulative renal survival rates for patients with types I, II, and III were 17.6%, 70.1%, and 44.3%, respectively.
  
  
  CONCLUSIONS
  Retrospective study, single-center experience.
  
  
  CONCLUSIONS
  Lupus nephritis may be the most common type of crescentic GN in China, followed by pauci-immune crescentic GN and IgA nephropathy. Almost half the patients presented with AKI, whereas 28.8% of cases showed chronic kidney disease. Clinical manifestations and outcomes varied according to crescentic GN type. The distinction between subtypes based on immunofluorescence and serologic findings has important implications for therapy and outcome.
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Shasha
authors.initials: S
authors.lastname: Chen
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. Electronic address: tang_dr@163.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Tang
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Xiang
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Li
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Weixin
authors.initials: W
authors.lastname: Hu
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Caihong
authors.initials: C
authors.lastname: Zeng
authors.affiliation: National Clinical Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001706:Biopsy / Q000379:methods; D002681:China / Q000453:epidemiology; D019468:Disease Management; D005455:Fluorescent Antibody Technique / Q000379:methods; D050533:Glomerular Basement Membrane / Q000276:immunology / Q000473:pathology; D005921:Glomerulonephritis / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012698:Serologic Tests / Q000379:methods
chemical_list: D001323:Autoantibodies
keywords: China; Crescentic glomerulonephritis; anti-glomerular basement membrane (anti-GBM) antibody; antineutrophil cytoplasmic antibody (ANCA); clinical follow-up; crescents; etiology; granular deposits; immune complex; kidney biopsy; kidney disease; kidney survival; linear deposits; pauci-immune; rapidly progressive; renal histology; renal pathology; type