POS-131 A STUDY OF ETIOLGIES AND SHORTTERM OUTCOME OF RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS IN A TERTIARY CARE HOSPITAL

ABSTRACT

Introduction: Rapidly progressive Glomerulonephritis (RPGN) is a syndrome which is caused by glomerulonephritis which results in rapid decline in renal function over a short period of time. Its histological hallmark is extensive crescent formation. It is a heterogeneous disease with various aetiologies leading to glomerular injury. The renal outcome will be dependent on the etiology and mode of treatment and timely initiation of treatment. Methods: The number of renal biopsies performed at our tertiary hospital over a period of 6 months of the study period were determined. The biopsies with crescentic glomerulonephritis were further scrutinized. The demographical data which includes, age, gender, and the baseline estimated glomerular filtration rate (eGFR) as determined by the Modified Diet in Renal Disease (MDRD) formula was collected. The serological test results of ANA, p-ANCA, c-ANCA, ASOT, anti-GBM antibody, C3 and C4 level were also be recorded. The underlying disease process of each of the RPGN cases were recorded into anti-GBM disease, Immune complex mediated, pauci-immune vasculitis, idiopathic or double antibody disease. Treatment of each patient and shorterm renal outcome were recorded. Results: Out of 112 biopsies done over a period of 6 months,16 were crescentric glomerulonephritis. The average age was 30.2 years, there were 5 male and 11 female patients. The majority of them (81.25%) were immune complex mediated and the remainder were ANCA mediated. The underlying cause of the 13 immune complex mediated crescentic glomerulonephritis was lupus nephritis in 8 (61.5%), post infection glomerulonephritis in 3 (23.07%), and antiGBM in 2 (15.38). Pauciimmune glomerulonephritis is 3 out of 16(18.75%) patients. Every patient was treated with immunosuppression. Plasma exchange was done in 2 antiGBM and 2 pauciimmune glomerulonephritis patients. out of 16,10 (62.5%) patients required dialyisis at the time of presentation. 4 out of 10 patients initiated on dialysis became dialysis independent with in 20 days. Renal recovery was not there in both antiGBM patients. one patient of pauciimmune glomerulonephritis succumbed due to Covid- 19 Iinfection. One patient with antiGBM GN had pulmonary alveolar haemorrhage which was responded to plasma exchange. One patient with IRGN was having chronic changes of diabetes on renal biopsy. [Formula presented] Conclusions: The most common cause of RPGN was immune complex mediated GN, mainly SLE lupus nephritis. In our study RPGN was more prevalent in females than males. With early and appropriate treatment renal recovery can be substantially good. Patients with antiGBM GN have poor renal outcomes. No conflict of interest