POS-123 Determinants of Outcome in Crescentic Glomerulonephritis: A Retrospective Study of 78 patients from Tunisia, North Africa

Abstract

Crescentic glomerulonephritis is a rare but severe disease. It is responsible for acute kidney injury which is potentially fatal mostly when associated with pulmonary haemorrhage. We evaluated in this study the outcomes of Tunisian patients with crescentic glomerulonephritis. Seventy-eight patients were consecutively diagnosed by kidney biopsy from January 2000 till Avril 2016 and followed for a median period of 230 days [2;1825 days]. Study endpoints were a response to therapy, end-stage renal disease (ESRD) and death. The median age of our patients was 49,6 years. The sex ratio was 1,5. Rapidly progressive renal insufficiency was present in all patients with the necessity of acute dialysis for 47,29% of patients. The pulmonary signs were the most frequent extrarenal manifestations. Hemorragic alveolitis was present in 16,7%. Anaemia and high white cells were observed respectively in 66% and 33,33% of patients. The most frequent etiologies of crescentic glomerulonephritis were ANCA associated glomerulonephritis objective in 50 patients, postinfectious glomerulonephritis in 12 patients and anti-glomerular basement membrane disease in 6 patients. Treatment was based on corticosteroids and cyclophosphamide. Eighteen patients were dead. Remission was observed in 37,83%. Renal failure was objective in 37,83%. The predictor factors of renal failure were old age, anaemia, high white cells, thrombocytosis, erythrocyte sedimentation rate, the percentage of crescents, cellular and fibrous crescents and interstitial fibrosis. The factors associated with mortality were the time between the apparition of symptoms and the instauration of treatment, the pulmonary injury, anaemia, high systolic hypertension and dialysis at presentation. The current report highlights the outcome of crescentic glomerulonephritis independently to their aetiology. Early diagnosis and treatment are essential for better outcomes.