Introduction:

Immunohistochemical staining of Ki-67, CD68 and Bcl-2 have been studied in glomerulonephritis. We aimed to assess these immunohistochemical staining features, hemodialysis initiation and 60 month mortality ratesin crescentic glomerulonephritis.

Methods:

In this retrospective study, patients, with a previous diagnosisof crescentic glomerulonephritis weredivided into two groups: Hemodialysis Initiated and Not Initiated groups. Kidney biopsy specimens’Ki-67, CD68 and Bcl-2 staining scores were defined as below 5% "0", 5-10% "+1", 11-20% "+2", over 20% "+3". Patients demographic, laboratory data, status ofhemodialysis initiation, and mortality wereobtained from medical records and immunohistochemical staining scores were compared between groups. Estimated glomerular filtration rates (eGFR) were assessed at 0, 6, and 12 months, except patients’ ongoing hemodialysis.

Results:

A total of 56 patients were diagnosed as crescentic glomerulonephritis. Pauci-immune crescentic glomerulonephritis (58.9%) was the most common etiology. Hemodialysis was initiated in 36 patients. Mean age, baseline creatinine, urea, C-reactive protein levels were significantly higher and, hemoglobin and proteinuria levels were significantly lower in the Hemodialysis Initiated group. Immunohistochemical staining scores were not significantlydifferentbetween groups. In Hemodialysis Initiated group, 8.33% of patients were recovered from hemodialysis. Mortality rates were 44,4% and 10% in patients in the group of hemodialysis initiated and not initiated group respectively.

When we combine the hemodialysis not initiated patients and patients recovered from hemodialysis;median eGFR atbaseline, 6th and 12th month were32.9, 43.9, and 58.0 mL/min/1.73m2, respectively (p=0.016).

Conclusion:

Hemodialysis initiation was associated with high mortality. Degree of immunohistochemical staining was similar in both groups. Increment in eGFR was documented in first year in patients, other than the ones on still on hemodialysis.

        · resumen en Español     · texto en Inglés     · Inglés ( pdf )