Anti-glomerular basement membrane (GBM)-antibody-mediated disease with normal renal function.

Published on Apr 1, 1998in Nephrology Dialysis Transplantation4.531
· DOI :10.1093/NDT/13.4.935
C Ang1
Estimated H-index: 1
,
Judy Savige39
Estimated H-index: 39
+ 4 AuthorsR S Sinclair1
Estimated H-index: 1
Sources
Abstract
Background. This study compared the clinical and laboratory characteristics of patients with anti-glomerular basement membrane (GBM) disease and normal renal function, with those of patients with anti-GBM disease where there was renal impairment. Methods. The medical records of the 14 patients who had presented with anti-GBM disease to our hospital in the past 20 years were reviewed. Results. Five (36%) had a normal serum creatinine or creatinine clearance at presentation. Other features were haemoptysis (2/5, 40%), macroscopic haematuria (2/5, 40%) or systemic symptoms (1/5, 20%). All five (100%) had some degree of haematuria, four (80%) had proteinuria of at least 1 g/day, and none was hypertensive. Anaemia, a raised WCC, or elevated ESR (>35 mm/h) occurred less often than in patients with impaired renal function (P 1 g/day in two (40%). Eight of the nine (89%) patients with impaired renal function survive, but all are currently being dialysed or have had a renal transplant. Conclusion. Patients with anti-GBM disease with normal renal function are not uncommon, and often have a good prognosis. There is less renal damage, possibly because of lower levels of circulating anti-GBM antibodies and less glomerular complement deposition.
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