Frequency of Crescentic Glomerulonephritis in Adults Presenting with Acute Kidney Injury.

Abstract

Objective: To determine the frequency of crescentic glomerulonephritis (CRGN) in adults presenting with acute kidney injury (AKI), defined according to the latest Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.

Study design: A cross-sectional observational design. Place and Duration of the Study: Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan, from April to October 2023.

Methodology: A total of 152 renal biopsies were obtained through a non-probability consecutive sampling technique, including all patients aged ≥18 years, of both genders, who presented with AKI and underwent renal biopsy. Demographics, clinical signs, and symptoms of CRGN were recorded. Data were stratified based on age, gender, and laboratory findings (serum creatinine (sCr) and serum urea). A post-stratification chi-square test was applied.

Results: Most participants were females (n = 97, 63.8%) with a mean age of 37 ± 18 years. Only 12 (8%) patients had CRGN. However, the majority of patients with AKI had acute tubular injury (n = 56, 36.8%), followed by cortical infarction (n = 27, 17.8%). No Significant difference was found between age (p = 0.814), gender (p = 0.143), serum urea (p = 0.117), and sCr levels (p = 0.229).

Conclusion: The study identified a significant but low prevalence of CRGN (8%) among AKI patients. This finding provides a crucial insight into the burden of CRGN in a developing country such as Pakistan, highlighting the need for heightened clinical awareness and diagnostic vigilance.

Key words: Acute kidney injury, Adults, Crescentic glomerulonephritis, Frequency, serum creatinine.