Biopsy-proven Kidney Diseases in the Elderly: Clinical Characteristics, Renal Histopathological Spectrum and Prognostic Factors

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2016 Sep 7

PMID 27596627

Citations 10

Authors

Yue Chen

Ping Li

Chunli Cui

Aihong Yuan

Kun Zhang

Chen Yu

Affiliations

Soon will be listed here.

Abstract

Objective To explore the clinical characteristics, renal histopathological spectrum and prognostic factors of biopsy-proven kidney diseases in the elderly. Methods A retrospective observational study was conducted in elderly patients who had received renal biopsies. Demographic, clinical and pathological data at the time of the biopsy were collected from the medical records. Follow-up records and prognostic factors were studied. Results The elderly (≥60 years) accounted for 74 of 434 (17.1%) native renal biopsies that were performed in a 9-year period. In the cohort of included elderly patients ( n = 72), the prevalence of nephrotic syndrome and acute kidney injury was 62.5% (45 of 72) and 40.3% (29 of 72), respectively. For elderly patients with primary glomerular diseases ( n = 44), membranous nephropathy was the most frequent pathological type (24 of 44; 54.5%). For elderly patients with secondary glomerular diseases ( n = 25), anti-neutrophil cytoplasmic antibody-associated vasculitis was the most frequent aetiology (nine of 25; 36.0%). Requirement for renal replacement therapy (RRT) was an independent risk factor for poor prognosis. Conclusions Kidney diseases in the elderly have distinctive characteristics. Requirement for RRT was associated with poor prognosis in the elderly with biopsy-proven kidney diseases.

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References

. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39(2 Suppl 1):S1-266. View

Verde E, Quiroga B, Rivera F, Lopez-Gomez J . Renal biopsy in very elderly patients: data from the Spanish Registry of Glomerulonephritis. Am J Nephrol. 2012; 35(3):230-7. DOI: 10.1159/000336307. View

Harmankaya O, Okuturlar Y, Kocoglu H, Kaptanogullari H, Yucel S, Ozkan H . Renal biopsy in the elderly: a single-center experience. Int Urol Nephrol. 2015; 47(8):1397-401. DOI: 10.1007/s11255-015-1035-8. View

Jin B, Zeng C, Ge Y, Le W, Xie H, Chen H . The spectrum of biopsy-proven kidney diseases in elderly Chinese patients. Nephrol Dial Transplant. 2014; 29(12):2251-9. DOI: 10.1093/ndt/gfu239. View

Yokoyama H, Sugiyama H, Sato H, Taguchi T, Nagata M, Matsuo S . Renal disease in the elderly and the very elderly Japanese: analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol. 2012; 16(6):903-20. DOI: 10.1007/s10157-012-0673-8. View

Zhu P, Zhou F, Zhao M . The renal histopathology spectrum of elderly patients with kidney diseases: a study of 430 patients in a single Chinese center. Medicine (Baltimore). 2014; 93(28):e226. PMC: 4603081. DOI: 10.1097/MD.0000000000000226. View

Ozturk S, Sumnu A, Seyahi N, Gullulu M, Sipahioglu M, Artan S . Demographic and clinical characteristics of primary glomerular diseases in Turkey. Int Urol Nephrol. 2014; 46(12):2347-55. DOI: 10.1007/s11255-014-0838-3. View

Nair R, Bell J, Walker P . Renal biopsy in patients aged 80 years and older. Am J Kidney Dis. 2004; 44(4):618-26. View

Rosner M . Acute kidney injury in the elderly. Clin Geriatr Med. 2013; 29(3):565-78. DOI: 10.1016/j.cger.2013.05.001. View

10.

Oliveira L, de Castro Cobo E, Machado J, Custodio F, da Silva M, de Oliveira F . Clinical and epidemiological prevalence of glomerulopathies elderly in the city of Uberaba - MG. J Bras Nefrol. 2015; 37(2):166-70. DOI: 10.5935/0101-2800.20150027. View

11.

Ma Y, Zuo L, Chen J, Luo Q, Yu X, Li Y . Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol. 2006; 17(10):2937-44. DOI: 10.1681/ASN.2006040368. View

12.

Vendemia F, Gesualdo L, Schena F, DAmico G . Epidemiology of primary glomerulonephritis in the elderly. Report from the Italian Registry of Renal Biopsy. J Nephrol. 2001; 14(5):340-52. View

13.

Katafuchi R, Kiyoshi Y, Oh Y, Uesugi N, Ikeda K, Yanase T . Glomerular score as a prognosticator in IgA nephropathy: its usefulness and limitation. Clin Nephrol. 1998; 49(1):1-8. View

14.

Naumovic R, Pavlovic S, Stojkovic D, Basta-Jovanovic G, Nesic V . Renal biopsy registry from a single centre in Serbia: 20 years of experience. Nephrol Dial Transplant. 2008; 24(3):877-85. DOI: 10.1093/ndt/gfn564. View

15.

Sumnu A, Gursu M, Ozturk S . Primary glomerular diseases in the elderly. World J Nephrol. 2015; 4(2):263-70. PMC: 4419136. DOI: 10.5527/wjn.v4.i2.263. View

16.

Rivera F, Lopez-Gomez J, Perez-Garcia R . Frequency of renal pathology in Spain 1994-1999. Nephrol Dial Transplant. 2002; 17(9):1594-602. DOI: 10.1093/ndt/17.9.1594. View

17.

Li L, Liu Z . Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies. Kidney Int. 2004; 66(3):920-3. DOI: 10.1111/j.1523-1755.2004.00837.x. View

18.

Yokoyama H, Sugiyama H, Narita I, Saito T, Yamagata K, Nishio S . Outcomes of primary nephrotic syndrome in elderly Japanese: retrospective analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol. 2014; 19(3):496-505. DOI: 10.1007/s10157-014-1022-x. View

19.

Brown C, Scheven L, OKelly P, Dorman A, Walshe J . Renal histology in the elderly: indications and outcomes. J Nephrol. 2011; 25(2):240-4. DOI: 10.5301/JN.2011.8447. View

20.

Chou Y, Lien Y, Hu F, Lin W, Kao C, Lai C . Clinical outcomes and predictors for ESRD and mortality in primary GN. Clin J Am Soc Nephrol. 2012; 7(9):1401-8. PMC: 3430959. DOI: 10.2215/CJN.04500511. View