BACKGROUND: The clinicopathological characteristics and outcome with pauci-immune crescentic glomerulonephritis (CreGN) are presumed to vary over time. We examined the characteristics and outcome of Japanese patients with CreGN according to the treatment periods. PATIENTS AND METHODS: From 1968 to 2011, we examined a total of 102 patients diagnosed with pauci-immune CreGN by renal biopsy. The patients were divided into three groups according to the treatment periods-Group I (1968-1988, n = 18), Group II (1989-2001, n = 37; when the nationwide survey of rapidly progressive glomerulonephritis [RPGN] was performed in Japan), and Group III (2002-2011, n = 47; after publication of the Japanese guideline for RPGN). RESULTS: There were no significant differences in blood pressure, renal function or anti-neutrophil cytoplasmic antibody titer between groups. On the other hand, the rate of crescent formation and degree of interstitial inflammatory cell infiltration were decreased in Group III. Serum creatinine (<3.0, 3.0-6.0, ≥6.0 mg/dL) and crescent formation (<30, 30-50, 50-80, ≥80 %) were significant renal prognostic factors in Group III [serum creatinine: hazard ratio (HR) 4.79, 95 % confidence interval (CI) 1.43-16.1, P = 0.011; crescent formation: HR 2.86, 95 % CI 1.06-7.73, P = 0.039]. Furthermore, renal survival rate of patients with crescent formation <50 % and patient survival rate of patients with serum creatinine <3 mg/dL were improved in Group III. CONCLUSION: Patients with CreGN were diagnosed in the early phase of crescent formation and outcome has improved in recent years.
BACKGROUND: The clinicopathological characteristics and outcome with pauci-immune crescentic glomerulonephritis (CreGN) are presumed to vary over time. We examined the characteristics and outcome of Japanese patients with CreGN according to the treatment periods. PATIENTS AND METHODS: From 1968 to 2011, we examined a total of 102 patients diagnosed with pauci-immune CreGN by renal biopsy. The patients were divided into three groups according to the treatment periods-Group I (1968-1988, n = 18), Group II (1989-2001, n = 37; when the nationwide survey of rapidly progressive glomerulonephritis [RPGN] was performed in Japan), and Group III (2002-2011, n = 47; after publication of the Japanese guideline for RPGN). RESULTS: There were no significant differences in blood pressure, renal function or anti-neutrophil cytoplasmic antibody titer between groups. On the other hand, the rate of crescent formation and degree of interstitial inflammatory cell infiltration were decreased in Group III. Serum creatinine (<3.0, 3.0-6.0, ≥6.0 mg/dL) and crescent formation (<30, 30-50, 50-80, ≥80 %) were significant renal prognostic factors in Group III [serum creatinine: hazard ratio (HR) 4.79, 95 % confidence interval (CI) 1.43-16.1, P = 0.011; crescent formation: HR 2.86, 95 % CI 1.06-7.73, P = 0.039]. Furthermore, renal survival rate of patients with crescent formation <50 % and patient survival rate of patients with serum creatinine <3 mg/dL were improved in Group III. CONCLUSION:Patients with CreGN were diagnosed in the early phase of crescent formation and outcome has improved in recent years.
Authors: Rachel B Jones; Alastair J Ferraro; Afzal N Chaudhry; Paul Brogan; Alan D Salama; Kenneth G C Smith; Caroline O S Savage; David R W Jayne Journal: Arthritis Rheum Date: 2009-07
Authors: Robert A F de Lind van Wijngaarden; Herbert A Hauer; Ron Wolterbeek; David R W Jayne; Gill Gaskin; Niels Rasmussen; Laure-Hélène Noël; Franco Ferrario; Rüdiger Waldherr; E Christiaan Hagen; Jan A Bruijn; Ingeborg M Bajema Journal: J Am Soc Nephrol Date: 2006-07-06 Impact factor: 10.121
Authors: David Jayne; Niels Rasmussen; Konrad Andrassy; Paul Bacon; Jan Willem Cohen Tervaert; Jolanta Dadoniené; Agneta Ekstrand; Gill Gaskin; Gina Gregorini; Kirsten de Groot; Wolfgang Gross; E Christiaan Hagen; Eduardo Mirapeix; Erna Pettersson; Carl Siegert; Alberto Sinico; Vladimir Tesar; Kerstin Westman; Charles Pusey Journal: N Engl J Med Date: 2003-07-03 Impact factor: 91.245
Authors: Christian Pagnoux; Alfred Mahr; Mohamed A Hamidou; Jean-Jacques Boffa; Marc Ruivard; Jean-Pierre Ducroix; Xavier Kyndt; François Lifermann; Thomas Papo; Marc Lambert; José Le Noach; Mehdi Khellaf; Dominique Merrien; Xavier Puéchal; Stéphane Vinzio; Pascal Cohen; Luc Mouthon; Jean-François Cordier; Loïc Guillevin Journal: N Engl J Med Date: 2008-12-25 Impact factor: 91.245