Rapidly Progressive Glomerulonephritis in Women: Clinical and histopathological Trends in Northwest Rajasthan, India

Abstract

Background: This retrospective study assessed the etiology, clinic-histological patterns, and outcomes of Rapidly Progressive Glomerulonephritis (RPGN) in 45 adult female patients from northwest Rajasthan. This study sought to identify the predictors influencing the outcomes of RPGN. Patients were diagnosed with RPGN based on renal biopsy showing crescents in more than 50% of glomeruli. Methods: The cohort was categorized into four groups (Type I, II, III, and IV) based on immunohistochemistry and outcomes were analyzed under four headings- complete remission, partial remission, end stage renal disease and mortality. Data on clinical history and physical examinations were collected. Results: Results revealed that Type II RPGN was the most common (57.77%), followed by Type III (22.22%), Type I (13.33%), and Type IV (6.66%). During follow-up, 12 patients (26.66%) died, and 17 patients (37.77%) progressed to End stage renal disease while 17 patients (37.77%) achieved remission. The ESRD group had presentation of oliguria, serum creatinine, and a need for hemodialysis at presentation (P<0.001 for all). Conclusion: The study found that Type II RPGN was the most prevalent form in this population. Key predictors of End stage renal disease included oliguria, glomerulosclerosis, and the need for hemodialysis at presentation. Respiratory failure, heart failure, and infections were significant mortality risk factors. This research highlights the poor prognosis of RPGN and underscores the need for early identification of high-risk patients to improve management and outcomes. Further studies are needed to confirm these findings and explore additional prognostic factors in this population.