THE FREQUENCY AND CUNICAL OUTCOME OF CRESLENTIC GLOMERULONEPHRITIS AMONG 532 RENAL BIOPSIES

In this study, the frequency of crescentic glomerulonephritis(GN) and the clinical outcome of the patients with crescentic GN were evaluated retrospectively among 532 renal biopsies performed between January 1990 and January 1996 in our unit. Crescentic GN was determined in 23 cases(4.3%); 18 of them were primary crescentic GN( Type I in 2, Type II in 10, Type III in 6), while 5 were secondary crescentic GN. Sixteen of 23 patients whose mean creatinin levels were 7.9±4.2 mg/dl (1.5-16.6) at the first admission, dialysis requirement occurred during hospitalization period. Pulse steroid was applied in 16 patients, pulse steroid and oral cyclophosphamide in 4, pulse steroid and plasmapheresis in 2, plasmapheresis and pulse cyclophosphamide in 1. In 10 cases(43%), initial response to the therapy was obtained, but end-stage renal disease developed in 6 of them in 1 year despite initial good response. Creatinine levels at the first examination and the percentage of crescent in the biopsies were significantly higher in the patients who do not show response to the therapy than those of the patients with initial response. At the end of follow-up period of mean 32±14 months, 17 of 20 surviving patients were on renal replacement therapy(14 on dialysis, 3 on renal transplantation), 3 had stable renal function.