Clinical Profile and Outcome of Patients with Clinical Diagnosis of Rapidly Progressive Glomerulonephritis: a Retrospective Study at Tikur Anbessa Specialized Hospital, Ethiopia
No Thumbnail Available
Date
2023-12-19
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome defined bythe rapid loss of renal function, accompanied by features of the nephritic syndrome withproteinuria, glomerular hematuria, and often oliguria. Early recognition and prompt diagnosisand treatment are crucial to prevent irreversible loss of renal function due to the limitedavailability of renal histopathology services.
Objective: To assess the clinical profile, efficacy, and safety outcome of immunosuppressivetherapy and determinants of outcomes in patients with clinically diagnosed Rapidly ProgressiveGlomerulonephritis who were on follow-up at Tikur Anbessa Specialized Hospital in Ethiopia.
Methods: This retrospective study was conducted among all patients who fulfilled the clinical criteria of RGPN who were managed in the hospital from January 1st, 2016 to January 31st, 2023 with at least six months of follow-up. Patient characteristics were presented using frequencies with percentages, mean ± standard deviation (SD) or median with Interquartile range (IQR)values, and graphs. Efficacy was assessed using the proportion of patients with decreased serum creatinine from baseline or stabilization of serum creatinine. Lack of response was evaluated as an increase in serum creatinine from baseline, requirement or dependence on renal replacementtherapy or death from renal cause. Safety was assessed using the proportion of patients with documented infections, hospitalizations for infection, or death from documented infections.Comparison of infection rate and patient outcome was made using Chi-square, independent ttest/ Mann-Whitney U-test, one-way ANOVA, and their non-parametric correlates whenassumptions of the tests failed.
Results: The median age of the participants was 37 years (IQR, 25.0-51.5 years) and 25/45 were females. The most common comorbid illness was hypertension (13/45). The median duration of illness was 14.0 days (IQR, 9.5-28.0 days) and the most frequent presenting symptoms were oliguria (35/45) and extra-renal symptoms of respiratory (22/45) like pulmonary (13/45), upperrespiratory tract (9/45), and rheumatologic (9/45) systems. The most common treatment complications were infection (15/45) and hematologic complications (4/45). Renal trhistopathology services.
Description
Keywords
Clinical Rapidly Progressive Glomerulonephritis renal recovery patient outcome Ethiopia, , ,