Crescentic glomerulonephritis: Data from the Spanish Glomerulonephritis Registry

Abstract

Background: Crescentic glomerulonephritis (CGN) is a histological finding that implies rapid deterioration of renal function and can be related to different diseases, such as type 1 or anti-glomerular basement membrane antibody (Goodpasture) disease, type 2 or immune complex CGN and type 3 or pauci-immune disease. Aim: The present study describes CGN and its characteristics based on the data from the Spanish Glomerulonephritis Registry. Methods: An analysis was made of all native renal biopsies obtained from patients during 1994-2013 and classified as CGN. A patient epidemiological and clinical data questionnaire was completed by the 120 centres involved. Results: A total of 21774 biopsies was performed, of which 2089 (8.1%) corresponded to CGN (211 type 1, 177 type 2 and 1701 type 3). Renal function was poorer in type 1 compared with types 2 and 3, and proteinuria was higher in type 2 compared to types 1 and 3. Patients diagnosed with CGN type 3 were older than those with types 1 and 2, but less hypertensive than the type 2 patients. No differences in the urine test findings were found between types 1 and 2. Microhaematuria was the most frequent feature in general, as well as in type 3 compared with types 1 and 2. The main indication for biopsy was acute renal injury. Age was the only difference between type 1 patients with and without alveolar haemorrhage (53 [33-67] vs 64 [46-73], P = 0.008). Conclusion: Although classified as the same entity, the different types of CGN have different features that must be taken into account.