Crescents and IgA Nephropathy: A Delicate Marriage
IgA nephropathy (IgAN) is a progressive disease with great variability in the clinical course. Among the clinical and pathologic features contributing to variable outcomes, the presence of crescents has attracted particular interest as a distinct pathological feature associated with severity. Severa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/13/3569 |
| _version_ | 1797408919192076288 |
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| author | Hernán Trimarchi Mark Haas Rosanna Coppo |
| author_facet | Hernán Trimarchi Mark Haas Rosanna Coppo |
| author_sort | Hernán Trimarchi |
| collection | DOAJ |
| description | IgA nephropathy (IgAN) is a progressive disease with great variability in the clinical course. Among the clinical and pathologic features contributing to variable outcomes, the presence of crescents has attracted particular interest as a distinct pathological feature associated with severity. Several uncontrolled observations have led to the general thought that the presence and extent of crescents was a prognostic indicator associated with poor outcomes. However, KDIGO 2021 guidelines concluded that either the presence or the relative number of crescents should not be used to determine the progression of IgAN nor should they suggest the choice of immunosuppression. Our aim is to report and discuss recent data on the debated issue of the value of active (cellular and fibrocellular) crescents in the pathogenesis and clinical progression of IgAN, their predictive value, and the impact of immunosuppression on renal function. We conclude that the value of crescents should not be disregarded, although this feature does not have an independent predictive value for progression in IgAN, particularly when considering immunosuppressed patients. An integrated overall evaluation of crescents with other active MEST scores, clinical data, and novel biomarkers must be considered in achieving a personalized therapeutic approach to IgAN patients. |
| first_indexed | 2024-03-09T04:06:36Z |
| format | Article |
| id | doaj.art-7147a061d91e49ed924afb486cec24f1 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T04:06:36Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7147a061d91e49ed924afb486cec24f12023-12-03T14:06:02ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011113356910.3390/jcm11133569Crescents and IgA Nephropathy: A Delicate MarriageHernán Trimarchi0Mark Haas1Rosanna Coppo2Nephrology Service, Hospital Britanico de Buenos Aires, Buenos Aires C1280 AEB, ArgentinaDepartment of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USAFondazione Ricerca Molinette, Regina Margherita Hospital, 10126 Turin, ItalyIgA nephropathy (IgAN) is a progressive disease with great variability in the clinical course. Among the clinical and pathologic features contributing to variable outcomes, the presence of crescents has attracted particular interest as a distinct pathological feature associated with severity. Several uncontrolled observations have led to the general thought that the presence and extent of crescents was a prognostic indicator associated with poor outcomes. However, KDIGO 2021 guidelines concluded that either the presence or the relative number of crescents should not be used to determine the progression of IgAN nor should they suggest the choice of immunosuppression. Our aim is to report and discuss recent data on the debated issue of the value of active (cellular and fibrocellular) crescents in the pathogenesis and clinical progression of IgAN, their predictive value, and the impact of immunosuppression on renal function. We conclude that the value of crescents should not be disregarded, although this feature does not have an independent predictive value for progression in IgAN, particularly when considering immunosuppressed patients. An integrated overall evaluation of crescents with other active MEST scores, clinical data, and novel biomarkers must be considered in achieving a personalized therapeutic approach to IgAN patients.https://www.mdpi.com/2077-0383/11/13/3569IgA nephropathycrescentsproteinuriaglomerular filtration rateOxford score |
| spellingShingle | Hernán Trimarchi Mark Haas Rosanna Coppo Crescents and IgA Nephropathy: A Delicate Marriage Journal of Clinical Medicine IgA nephropathy crescents proteinuria glomerular filtration rate Oxford score |
| title | Crescents and IgA Nephropathy: A Delicate Marriage |
| title_full | Crescents and IgA Nephropathy: A Delicate Marriage |
| title_fullStr | Crescents and IgA Nephropathy: A Delicate Marriage |
| title_full_unstemmed | Crescents and IgA Nephropathy: A Delicate Marriage |
| title_short | Crescents and IgA Nephropathy: A Delicate Marriage |
| title_sort | crescents and iga nephropathy a delicate marriage |
| topic | IgA nephropathy crescents proteinuria glomerular filtration rate Oxford score |
| url | https://www.mdpi.com/2077-0383/11/13/3569 |
| work_keys_str_mv | AT hernantrimarchi crescentsandiganephropathyadelicatemarriage AT markhaas crescentsandiganephropathyadelicatemarriage AT rosannacoppo crescentsandiganephropathyadelicatemarriage |