Crescentic nephritis (RPGN)

Crescentic nephritis is also known as Rapidly Progressive GlomeruloNephritis, or RPGN. It is a severe and usually very acute type of kidney inflammation that can cause loss of kidney function within days to weeks.

As many causes of crescentic nephritis are treatable, it is important to make the diagnosis quickly so that kidney function can be saved.

What is crescentic nephritis?

Very severe inflammation inside the filtering units breaks the filtering membrane (the glomerular basement membrane, GBM), causing leakage of blood proteins into the urinary space. This makes the cells in the urinary space multiply to form the crescent.

Normal	Crescent
The photos (above) and diagrams below them illustrate a normal glomerulus on the left, and one with a crescent on the right. The TUFT which contains the blood that is being filtered (the tiny blood vessels show up as white spaces in the normal glomerulus) has been crushed by the crescent on the right. US = urinary space in the normal glomerulus (shaded yellow).

What can cause crescentic nephritis?

Some important causes of severe crescentic nephritis are:

	Vasculitis	Usually responds well to treatment
	SLE (Lupus)	Response to treatment usually good
	Goodpasture's disease	Response can be good if treated early
	IgA nephropathy	Response uncertain

What is the treatment?

The initial treatment for most forms of crescentic nephritis is quite similar, although the details and follow-on treatment vary according to the cause. Immunosuppressive drugs are commonly used - these reduce the activity of your immune system.

Further information

Further information on the diseases that might cause crescentic nephritis is available from the links above, or try a SEARCH.

This information is published from the Renal Unit at the Royal Infirmary of Edinburgh, Scotland, UK, Renal@ed.ac.uk The author for this page was Neil Turner. It was written in October 2000 and last updated on Tuesday, July 25, 2006.

Please be aware that while we have made all efforts to ensure that this brief information is accurate, we cannot guarantee that there are no mistakes. Also that the best management for individual patients may differ from that outlined here. Only the doctors caring for the patient will be able to advise on this.