What Is Crescentic Nephritis?

Crescentic nephritis is a serious and rapidly progressing kidney disease that can lead to death if not treated. Patients with this condition develop severe inflammation in the glomeruli, the small units inside the kidney that provide a mechanism for filtering blood before delivering it into individual nephrons for processing. Over time, the clusters of blood vessels in the glomeruli, known as “tufts,” begin leaking cellular proteins. These in turn create a crescent-shaped formation that compresses each tuft. It is less able to filter blood as a result, slowing down the kidneys and making it harder for the kidneys to eliminate toxins and retain useful nutrients.

This condition may be caused by underlying problems such as systemic lupus erythematosus (SLE), a number of genetic diseases, or vasculitis. Other cases have no known cause. Determining the cause, if possible, is important, because this can indicate which treatment would be most appropriate and effective for the patient. Rapid intervention can make crescentic nephritis survivable, but requires swift action to identify and treat the problem. Treatment usually involves supportive therapy and immunosuppressive drugs to stop the inflammation.

Early symptoms can be ambiguous. Patients might feel tired, nauseous, and weak. As kidney function declines, the urine can turn dark and people may notice issues like difficulty urinating, lack of appetite, and growing fatigue. Medical testing can show that the blood chemistry is abnormal, indicating something is going wrong in the kidneys, but the definitive test is a biopsy from the kidneys, which will allow a pathologist to look at individual structures and cells. This can show the tell-tale crescents indicative of crescentic nephritis.

An alternate name for crescentic nephritis is Rapidly Progressive Glomerulonephritis (RPGN), because it may onset in as little as three months and can be very aggressive. Patients at risk for this condition may be regularly screened for signs of problems with kidney function. This allows medical providers to catch, and treat, the issue as early as possible. In other cases, people with signs of kidney malfunction need to be quickly and carefully evaluated to find out what is happening and develop a course of treatment appropriate to the situation.

After treatment for crescentic glomerulonephritis, the patient may experience lingering health problems or could recover kidney function. The response depends on the cause and how early the patient received treatment. Some people may need dialysis to compensate for failing or damaged kidneys, or could require a kidney transplant to replace a badly damaged organ. In addition, patients may be advised to take care in the future to prevent another episode of crescentic nephritis.