Loss of renal function over a short period of time progressing to end-stage renal disease in most untreated patients within a period of weeks to months
RPGN
Characterized morphologically by extensive crescent formation (crescentic glomerulonephritis)
May present as a sequel to severe acute nephritic syndrome (gross hematuria, oliguria, hypertension, edema), or may have an insidious onset (fatigue, edema)
Hematuria is an essential finding +/- proteinuria
Renal size is normal
Poor prognostic signs are oliguria (<400ml/day) and GFR<15ml/min
An accurate and urgent diagnosis is essential in the patient presenting with clinical findings suggestive of RPGN in order to save the kidney
Patients should undergo appropriate serologic assays and a kidney biopsy
Early initiation of appropriate therapy is essential to minimize the degree of irreversible renal injury (reversible if treated within a few months window)
Management of RPGN
1. Steroids (IV pulse for 3 days then oral)
2. Cyclophosphamide or azathioprine or mycophenolate
