Crescentic glomerulonephritis (CrGN) is characterized by the presence of crescents in more than 50% of glomeruli. This study aims to identify the etiology and clinicopathological features and outcomes of CrGN. In this observational study, 80 biopsy-proven CrGN were included. Patients’ demographic profile, clinical parameters, treatments, and outcomes were collected and analyzed. The mean age in our study population was 40.86 ± 16.5 years. Type II CrGN was the most common type of CrGN. Female predominance was observed in type I and type II CrGN. The highest percentage of glomeruli with crescents was seen in type I (87 ± 15.2%, P = 0.04), followed by type III and type II. At the last follow-up, mean estimated glomerular filtration rate was 25.8 ± 11.41 mL/min/1.73 m2 and was significantly lower in type I CrGN (11.6 ± 4.8 mL/min/1.73 m2 P = 0.001). The overall 5-year renal survival rate was 55% and was highest in type II (69.4%), followed by type III and type I (27.3%) CrGN (P = 0.0299). In our study, oliguria at the time of presentation, percentage of crescents, glomerular sclerosis, and moderate/severe IFTA were associated with poor renal outcomes. In conclusion, CrGN was seen in 5.7% of kidney biopsies in our study. Type II CrGN was the most common type of CrGN followed by type III CrGN. Renal survival was poor in type I CrGN patients compared to type II and type III CrGN. Also, oliguria, crescents, glomerular sclerosis, and moderate/severe IFTA were associated with poor renal outcomes.

No abstract

No abstract

Clinicopathological presentation of lupus nephritis (LN) patients varies with different race and ethinicity of the population. Only few studies describe clinicopathological spectrum of LN patients in the Indian population. The aim of this study was to determine the clinicopathological spectrum of LN in the North-East Indian population. This was a retrospective observational study that included patients with LN at a tertiary care center in North-East India from March 2007 to August 2018. Clinical and histopathological data at the time of presentation were collected from hospital records. Renal biopsies were examined by light microscopy and direct immunofluorescence techniques. A total of 340 patients of LN were included in this study. The mean age of presentation was 22.42 ± 4.3 years. The minimum age at presentation was 8 years and 18.8% belonged to the <18 year age group. The present study showed a male:female ratio of 1:8. The majority of patients were of class IV (71.9%). Arthralgia (47.1%) and anemia (60.3%) were the most common presenting symptom and sign, respectively. Immunoglobulin (Ig) G was the most abundant immunoglobulin (positive in 98.47%) and the least positive was IgA (positive in 41.18%). Complement (C) 3 and C1q were positive in all. Full house deposition was found in 59.3% of the biopsies. The rates of hypertension, microscopic hematuria, renal dysfunction, and nephrotic syndrome were 43.5, 59.12, 45.9, and 35.3%, respectively. Patients of LN in the North-East Indian population present at an earlier age with a more severe form of the disease (class IV) at the time of presentation.

Background Pulmonary hypertension is a disorder which worsens systemic diseases. One of the important underlying pathology is end stage chronic kidney disease The aim of this study was to assess the incidence of unexplained PHT, and to relate this to the cardiovascular status and arteriovenous fistula characteristics in ESKD patients on maintenance hemodialysis Methods: 159 patients with end stage kidney disease on maintenance hemodialysis were evaluated, 103 were excluded. Clinical, laboratory parameters were recorded. Systolic Pulmonary artery pressure and cardiac functions were evaluated by echocardiography. Flow across arteriovenous fistula was assessed by Doppler sonography. Patients were divided between the group with and without pulmonary hypertension. It was a cross sectional study. Result: Out of 159 patients, 56 patients who fulfilled inclusion criteria were evaluated, 36% had systolic pulmonary artery pressure of 35 mm Hg, mean age was 52.42 ± 9.12 years, 71.4% were males, and mean duration of end stage kidney disease was 33.66 ±11.56 months. Pulmonary hypertension patients were exposed to longer duration of hemodialysis therapy (p=0.0001) as compared to the patients with no pulmonary hypertension group, they also had a longer duration of functional Arterio venous fistula (p=0.0001), and flow across Arterio venous fistula was significantly more in pulmonary hypertension group (p=0.022), and these also had higher cardiac output (p=0.0001).  Patients with Pulmonary hypertension were significantly more anemic, had more hypoalbuminemia and more interdialytic weight gain. Conclusions:  Pulmonary hypertension is frequent in end-stage kidney disease patients on maintenance hemodialysis. It appears to be a late complication of hemodialysis with surgically created AVF with implications on cardiovascular status. Keywords: Arterio venous fistula (AVF), End-stage kidney disease (ESKD), Maintenance hemodialysis (MHD), pulmonary hypertension (PHT).Systolic pulmonary artery pressure (sPAP)