Rapidly progressive glomerulonephritis

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Crescentic glomerulonephritis (2)

Rapidly Progressive Glomerulonephritis (RPGN) is a severe form of glomerulonephritis characterized by rapid loss of kidney function, typically over days to weeks. RPGN is a medical emergency that requires prompt diagnosis and treatment to prevent irreversible kidney failure. The condition is also known as crescentic glomerulonephritis due to the crescent-shaped formations observed in the glomeruli during histological examination.

Causes[edit | edit source]

RPGN can be caused by a variety of underlying diseases, which are broadly classified into three categories based on the presence of certain antibodies and the pattern of immune deposits seen on kidney biopsy:

Symptoms[edit | edit source]

The symptoms of RPGN are often severe and can include:

  • Hematuria (blood in the urine)
  • Proteinuria (protein in the urine)
  • Edema (swelling), particularly in the legs and feet
  • Hypertension (high blood pressure)
  • Oliguria (reduced urine output)
  • Fatigue and weakness
  • Loss of appetite and weight loss

Diagnosis[edit | edit source]

Diagnosis of RPGN involves a combination of clinical evaluation, laboratory tests, and kidney biopsy. Laboratory tests may show elevated levels of creatinine and urea, indicating reduced kidney function. Urinalysis typically reveals hematuria and proteinuria. A kidney biopsy is essential for confirming the diagnosis, determining the underlying cause, and guiding treatment.

Treatment[edit | edit source]

Treatment of RPGN aims to control the symptoms, prevent further kidney damage, and treat the underlying cause. It may include:

  • High doses of corticosteroids to reduce inflammation
  • Cytotoxic drugs to suppress the immune system
  • Plasmapheresis to remove antibodies from the blood (particularly in cases caused by anti-GBM antibodies)
  • Management of complications such as hypertension and edema

Prognosis[edit | edit source]

The prognosis of RPGN varies depending on the underlying cause, the severity of kidney damage at the time of diagnosis, and the response to treatment. Early and aggressive treatment can improve outcomes, but some patients may progress to chronic kidney disease or end-stage renal disease, requiring dialysis or kidney transplantation.


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Contributors: Prab R. Tumpati, MD