The Treatment of Crescentic Glomerulonephritis

Crescents often appear during crescentic glomerulonephritis which is a kind of proliferative covering epithelial cell nephropathy. The normal glomerulus is like a ball with twisting blood capillary in the inner part and one stratum of covering epithelial cell in the outer part. The space between inner part and outer part is called Bowman’s capsule. When glomerular capillary wall(GCW) is damaged so as to make basilar membrane break, the leaked red blood cells, fibrin, infiltrating monocyte, and proliferative covering epithelial cell fill the Bowman’s capsule forming hemispheric structure which is like crescent, so it is called as “crescent”. If glomerulus with crescents is up to 50% among all the glomeruli, and the crescent area is over 50%, this disease condition is crescentic glomerulonephritis. How crescents are produced and what roles crescents play, and how to treat crescents, these questions have been puzzling many patients.
Roughly crescents are composed by some cells and extracellular matrix(ECM). These mentioned cells include proferative covering epithelial cells and those cells which leak from blood capillary such as macrophage, lymphocyte, neutrophile granulocyte, and fibroblast. ECM includes fibrin, collagen, and components of basilar membrane. Due to different nephritis and stages, the components of crescents are various. In the early stage of CKD, basilar membrane is broken, and macrophage and neutrophile granulocyte are immersed into Bowman’s capsule. These leaked cells secrete inflammatory factors to stimulate the proliferation of covering epithelial cells in the result that cellular crescent is formed whose main components are proliferated covering epithelial cells and macrophage; with long-term disease, fibroblasts enter through the crevice of Bowman’s capsule. With more fibrin and collagen and less cells, cellular fibrous crescent; in the end stage, cell components disappear, complete fibrous crescent appears. At last, glomerulosclerosis occurs and renal functions break down.
As for the treatment of Crescentic Glomerulonephritis, the first reference is creatinine. When creatinine is blow 256 umol/min, patients should take hormones like immunosuppressive (agent), steroid to block excessive immune reactions to prevent the production of immune complex. And then, we use Micro-Chinese Medicine Osmotherapy to dilate blood vessels so as to better micro blood circulation of kidneys. At last, we apply Immunotherapyation to repair damaged renal cells and recover renal normal structure. If creatinine is over 256, hormones should not be applied, because in the moment, hormones can increase creatinine greatly, and are slight effective to Proteinuria and other symptoms.

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