Zeki Aydin1, Kultigin Turkmen2, Fatih Dede3, Emre Yasar4, Savas Ozturk5, Mehmet Aydin6, Erhan Tatar7, Garip Sahin8, Gulizar Manga9, Ozgur Oto10, Abdullah Sumnu11, Eray Eroglu12, Tamer Dincer13, Belda Dursun14, Necmi Eren15, Mustafa Sevinc16, Fatma Betul Guzel17, Serkan Yalin18, Sim Kutlay19, Suheyla Apaydin20, Haci Bayram Berktas21, Sinan Kazan22, Hamad Dheir23, Feyza Bora24, Taner Basturk16, Idris Sahin21. 1. Department of Nephrology, Darica Farabi Training and Research Hospital, Fevzi Çakmak, Dr. Zeki Acar Ave. No:62, 41700, Darica, Kocaeli, Turkey. zekiaydindr@yahoo.com. 2. Department of Internal Medicine, Division of Nephrology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey. 3. Department of Nephrology, Ankara Numune Training and Research Hospital, Ankara, Turkey. 4. Department of Internal Medicine, Division of Nephrology, Gazi University School of Medicine, Ankara, Turkey. 5. Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey. 6. Department of Internal Medicine, Division of Nephrology, Uludag University School of Medicine, Bursa, Turkey. 7. Department of Nephrology, Bozyaka Training and Research Hospital, Izmir, Turkey. 8. Department of Internal Medicine, Division of Nephrology, Osmangazi University School of Medicine, Eskisehir, Turkey. 9. Department of Nephrology, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey. 10. Department of Internal Medicine, Division of Nephrology, Istanbul University School of Medicine, Istanbul, Turkey. 11. Department of Nephrology, Medipol University School of Medicine, Istanbul, Turkey. 12. Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey. 13. Department of Internal Medicine, Division of Nephrology, Istanbul Cerrahpasa University School of Medicine, Istanbul, Turkey. 14. Department of Internal Medicine, Division of Nephrology, Pamukkale University School of Medicine, Denizli, Turkey. 15. Department of Internal Medicine, Division of Nephrology, Kocaeli University School of Medicine, Kocaeli, Turkey. 16. Department of Nephrology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey. 17. Department of Internal Medicine, Division of Nephrology, Sutcu Imam University School of Medicine, Kahramanmaras, Turkey. 18. Department of Nephrology, Dr Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey. 19. Department of Internal Medicine, Division of Nephrology, Ankara University School of Medicine, Ankara, Turkey. 20. Department of Nephrology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey. 21. Department of Internal Medicine, Division of Nephrology, Inonu University School of Medicine, Malatya, Turkey. 22. Department of Nephrology, Afyonkarahisar SBU School of Medicine, Afyonkarahisar, Turkey. 23. Department of Internal Medicine, Division of Nephrology, Sakarya University School of Medicine, Sakarya, Turkey. 24. Department of Internal Medicine, Division of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey.
Abstract
BACKGROUND: In our study, diagnostic and demographic characteristics of patients diagnosed with RPGN by biopsy, clinical and laboratory findings in our country were investigated. METHODS: Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. According to their types, RPGN patients were classified as type 1 (anti-GBM related), type 2 (immuncomplex related) and type 3 (pauci-immune). RESULTS: Of 3875 patients, 200 patients with RPGN (mean age 47.9 ± 16.7 years) were included in the study which constitutes 5.2% of the total glomerulonephritis database. Renal biopsy was performed in 147 (73.5%) patients due to nephritic syndrome. ANCA positivity was found in 121 (60.5%) patients. Type 1 RPGN was detected in 11 (5.5%), type 2 RPGN in 42 (21%) and type 3 RPGN in 147 (73.5%) patients. Median serum creatinine was 3.4 (1.9-5.7) mg/dl, glomerular filtration rate was 18 (10-37) ml/min/1.73m2 and proteinuria 2100 (1229-3526) mg/day. The number of crescentic glomeruli ratio was ratio 52.7%. It was observed that urea and creatinine increased and calcium and hemoglobin decreased with increasing crescentic glomerular ratio. CONCLUSIONS: Our data are generally compatible with the literature. Advanced chronic histopathological findings were prominent in the biopsy of 21 patients. Early biopsy should be performed to confirm the diagnosis of RPGN and to avoid unnecessary intensive immunosuppressive therapy. In addition to the treatments applied, detailed data, including patient and renal survival, are needed.
BACKGROUND: In our study, diagnostic and demographic characteristics of patients diagnosed with RPGN by biopsy, clinical and laboratory findings in our country were investigated. METHODS: Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. According to their types, RPGNpatients were classified as type 1 (anti-GBM related), type 2 (immuncomplex related) and type 3 (pauci-immune). RESULTS: Of 3875 patients, 200 patients with RPGN (mean age 47.9 ± 16.7 years) were included in the study which constitutes 5.2% of the total glomerulonephritis database. Renal biopsy was performed in 147 (73.5%) patients due to nephritic syndrome. ANCA positivity was found in 121 (60.5%) patients. Type 1 RPGN was detected in 11 (5.5%), type 2 RPGN in 42 (21%) and type 3 RPGN in 147 (73.5%) patients. Median serum creatinine was 3.4 (1.9-5.7) mg/dl, glomerular filtration rate was 18 (10-37) ml/min/1.73m2 and proteinuria 2100 (1229-3526) mg/day. The number of crescentic glomeruli ratio was ratio 52.7%. It was observed that urea and creatinine increased and calcium and hemoglobin decreased with increasing crescentic glomerular ratio. CONCLUSIONS: Our data are generally compatible with the literature. Advanced chronic histopathological findings were prominent in the biopsy of 21 patients. Early biopsy should be performed to confirm the diagnosis of RPGN and to avoid unnecessary intensive immunosuppressive therapy. In addition to the treatments applied, detailed data, including patient and renal survival, are needed.
Authors: Savas Ozturk; Abdullah Sumnu; Nurhan Seyahi; Mustafa Gullulu; Murat Sipahioglu; Serra Artan; Zerrin Bicik; Sim Kutlay; Mustafa Keles; Deren Oygar; Ali Riza Odabas; Mansur Kayatas; Belda Dursun; Hayriye Sayarlioglu; Sinan Trablus; Dilek Guven Taymez; Ali Abbas Ozdemir; Gulizar Manga Sahin; Bulent Altun; Alper Azak; Lutfullah Altintepe; Gultekin Suleymanlar; Mehmet Koc; Yilmaz Selcuk; Rumeyza Kazancioglu; Reha Erkoc; Meltem Gursu; Mehmet Kucuk; Selma Alagoz Akcaoglu; Abdulmecid Yıldız; Aydin Unal; Ozger Akarsu; Kenan Ates; Erdem Cankaya; Aydin Turkmen Journal: Int Urol Nephrol Date: 2014-09-30 Impact factor: 2.370