Table of Contents
ISRN Pediatrics
Volume 2011 (2011), Article ID 507298, 5 pages
http://dx.doi.org/10.5402/2011/507298
Clinical Study

Glomerulonephritis with Crescents in Children: Etiology and Predictors of Renal Outcome

1Department of Pathology, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia
2Department of Pediatrics, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia
3Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh 11426, Saudi Arabia
4Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh 11426, Saudi Arabia

Received 16 August 2011; Accepted 7 September 2011

Academic Editors: M. Adhikari and F. Sauvat

Copyright © 2011 K. Alsaad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To investigate the clinicopathological features and outcome of glomerulonephritis with crescents among Saudi children. Method. This is a retrospective study of cases of crescentic glomerulonephritis (CrGN) seen over a 9-year period. Histological features and renal function were recorded. Results. Thirty-seven cases were enrolled. The mean percent of glomeruli with crescents was 39% (±19). Lupus nephritis (LN) was the commonest etiology (54.1%). At presentation, the serum creatinine (SCr) was 218.2 (±174.3) umol/l, and 57.1% of the cases had nephrotic range proteinuria. By the end of the observation period, SCr dropped to 81.0 (±67.7) umol/l ( 𝑃 = 0 . 0 0 1 ). Worsening renal function was associated with younger age ( 𝑃 = 0 . 0 0 2 ), non-LN etiology ( 𝑃 = 0 . 0 1 ), more crescents ( 𝑃 = 0 . 0 1 9 ), and ATN ( 𝑃 = 0 . 0 5 ). At the end of the followup, more patients in the LN group were dialysis-free ( 𝑃 = 0 . 0 1 7 ) and had improved renal function (0.01) than in the non-LN group. Using multivariate analysis, the only independent factor found to predict need for dialysis or change in SCr level was percent of globally sclerosed glomeruli ( 𝑃 = 0 . 0 3 4 ). Conclusion. LN is the main cause of CrGN in our cohort of children. The LN group had less globally sclerorsed glomeruli and better renal prognosis than the non-LN group.