Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study
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 cre...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/8/2385 |
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| author | Joseph G. Maliakkal M. John Hicks Mini Michael David T. Selewski Katherine Twombley Michelle N. Rheault Meredith Seamon Jason M. Misurac Cheryl L. Tran Loretta Reyes Joseph T. Flynn Ali M. Onder Alexandru R. Constantinescu Vaishali Singh Cynthia Pan Abiodun Omoloja Qiang Wu William E. Smoyer Guillermo Hidalgo Scott E. Wenderfer |
| author_facet | Joseph G. Maliakkal M. John Hicks Mini Michael David T. Selewski Katherine Twombley Michelle N. Rheault Meredith Seamon Jason M. Misurac Cheryl L. Tran Loretta Reyes Joseph T. Flynn Ali M. Onder Alexandru R. Constantinescu Vaishali Singh Cynthia Pan Abiodun Omoloja Qiang Wu William E. Smoyer Guillermo Hidalgo Scott E. Wenderfer |
| author_sort | Joseph G. Maliakkal |
| collection | DOAJ |
| description | 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 (<i>p</i> = 0.003) and a 2% decrease in log odds of renal survival at last follow-up (<i>p</i> < 0.001). These findings provide an evidence base for enrollment criteria for crescentic glomerulonephritis in future clinical trials. |
| first_indexed | 2024-03-10T18:12:07Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T18:12:07Z |
| publishDate | 2020-07-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-7c7e96a94dc64e33899ea6b74468e1df2023-11-20T08:00:45ZengMDPI AGJournal of Clinical Medicine2077-03832020-07-0198238510.3390/jcm9082385Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort StudyJoseph G. Maliakkal0M. John Hicks1Mini Michael2David T. Selewski3Katherine Twombley4Michelle N. Rheault5Meredith Seamon6Jason M. Misurac7Cheryl L. Tran8Loretta Reyes9Joseph T. Flynn10Ali M. Onder11Alexandru R. Constantinescu12Vaishali Singh13Cynthia Pan14Abiodun Omoloja15Qiang Wu16William E. Smoyer17Guillermo Hidalgo18Scott E. Wenderfer19Pediatric Nephrology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 77030, USAPathology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USAPediatric Nephrology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 77030, USAPediatric Nephrology, Medical University of South Carolina, Charleston, SC 29425, USAPediatric Nephrology, Medical University of South Carolina, Charleston, SC 29425, USAPediatric Nephrology, University of Minnesota, Minneapolis, MN 55455, USAPediatric Nephrology, The University of Utah, Salt Lake City, UT 84112, USAPediatric Nephrology, University of Iowa, Iowa City, IA 52242, USAPediatric Nephrology, Mayo Clinic, Rochester, MN 55902, USAPediatric Nephrology, Emory University, Atlanta, GA 30322, USAPediatric Nephrology, University of Washington, Seattle, WA 98115, USAPediatric Nephrology, University of West Virginia, Morgantown, WV 26506, USAPediatric Nephrology, Joe DiMaggio Children’s Hospital, Hollywood, FL 33021, USAPediatric Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, USAPediatric Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, USAPediatric Nephrology, Wright State University, Dayton, OH 45435, USABiostatistics, East Carolina University, Greenville, NC 27858, USAPediatric Nephrology, The Ohio State University and Nationwide Children’s Hospital, Columbus, OH 43205, USAPediatric Nephrology, East Carolina University, Greenville, NC 27858, USAPediatric Nephrology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 77030, USAThere 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 (<i>p</i> = 0.003) and a 2% decrease in log odds of renal survival at last follow-up (<i>p</i> < 0.001). These findings provide an evidence base for enrollment criteria for crescentic glomerulonephritis in future clinical trials.https://www.mdpi.com/2077-0383/9/8/2385glomerulonephritistargeted biologic therapiesimmunosuppressioncellular crescentsfibrous crescents |
| spellingShingle | Joseph G. Maliakkal M. John Hicks Mini Michael David T. Selewski Katherine Twombley Michelle N. Rheault Meredith Seamon Jason M. Misurac Cheryl L. Tran Loretta Reyes Joseph T. Flynn Ali M. Onder Alexandru R. Constantinescu Vaishali Singh Cynthia Pan Abiodun Omoloja Qiang Wu William E. Smoyer Guillermo Hidalgo Scott E. Wenderfer Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study Journal of Clinical Medicine glomerulonephritis targeted biologic therapies immunosuppression cellular crescents fibrous crescents |
| title | Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study |
| title_full | Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study |
| title_fullStr | Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study |
| title_full_unstemmed | Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study |
| title_short | Renal Survival in Children with Glomerulonephritis with Crescents: A Pediatric Nephrology Research Consortium Cohort Study |
| title_sort | renal survival in children with glomerulonephritis with crescents a pediatric nephrology research consortium cohort study |
| topic | glomerulonephritis targeted biologic therapies immunosuppression cellular crescents fibrous crescents |
| url | https://www.mdpi.com/2077-0383/9/8/2385 |
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