Introduction:
The formation of crescent in Lupus Nephritis has important clinical significance. Our study assesses the relationship of various clinical and histological parameters with crescent formation in LN patients.
Methods:
The patients who underwent kidney biopsy for suspecting lupus nephritis between 2026 to 2023 were screened. Out of which patient who had crescent in kidney biopsy in LN were included. The crescents were estimated in percentage. Activity index and chronicity index were measured. Laboratory parameters like hemoglobin, leukocyte count, platelets, serum electrolytes, renal function test, serum albumin, globulin level, proteinuria, eGFR, proteinuria, and complement level were recorded at the time of kidney biopsy.
Results:
A total 471 patients underwent kidney biopsy, out of which 54 had lupus nephritis and 40 had crescent in their kidney biopsy were included. The mean age was 27.83±6.99 yrs; 37 (92.5%) were female. The mean serum creatinine was 2.06 ±1.87 mg/dl, eGFR was 59.25 ±37.73 ml/min, 24-hour urine protein was 3.68 ± 2.11 gm, and 26 (65 %) patients had hypertension during the biopsy. Twenty-four patients (60 %) were diagnosed with SLE with lupus nephritis at presentation. The most common pathological lesion was LN IV in 22 (55 %) patients, followed by LN III (22.5%), LN IV+V (17.5%) and LN III+V (5%). Seven (17.5%) had crescent <10%; 17 (42.5%) had crescent between 10-25%; 8 (20%) had crescent between 26-49% and ≥50% each. Most of the crescents were cellular, 21 (52.5%), followed by a mixture of cellular and fibro-cellular (40%) and a mixture of cellular, fibro-cellular, and fibrous (7.5%). Among various laboratory parameters, serum albumin and globulin were strongly associated with crescent formation (-0.375, p=0.017, and -0.388, p=0.013, respectively). In addition, serum complements level, lupus nephritis class IV, and activity index were significantly associated with crescent formation (p=0.036; p=0.018; p=0.026, respectively). Activity index was independently associated with crescent formation (β=0.526, CI =1.27 -5.23; p=0.002).
Conclusions:
In our study, serum albumin, globulin, serum complement, LN class IV, and activity index were significantly associated with crescent formation.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.