Clinico-Patholgical Findings in Iranian Elderly Kidney Patients – A Case Series Study
Mojgan Asgari, Shahrzad Ossareh, Shokoufeh Savaj, Ezatollah Abdi, Yousef Ataipour, Tahereh Malakoutian. Hasheminejad Clinical Research Developing Center (HCRDC), Tehran University of Medical Sciences (TUMS), Tehran, Islamic Republic of Iran; Firoozgar Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Islamic Republic of Iran
Background: Most of the renal lesions in the elderly are considered to be the result of aging but renal biopsies in the elderly show frequent finding of various renal pathologies, with some differences in distribution and clinical presentation compared to the younger patients. We planned this study to investigate the cause of renal biopsy and clinico-pathologic presentations of renal biopsy findings in the elderly patients in our center.
Design: Data from 2268 patients (56% male, mean age: 37.8+/- 16 years) between 1997 and 2011 were collected in questionnaires including demographic data, renal syndrome at presentation and laboratory findings. 182 Patients older than 64 years of age were defined as the elderly group.
Results: Elderly group showed the same distribution of renal biopsy findings of all patinets, however in this group amyloidosis, IgAN and diffuse crescentic GN, diabetic nephropathy and multiple myeloma were the most frequent diagnoses after MG and FSGS. There were higher prevalence of male patients (p<0.004), hypertension (p<0.001) and azotemia. Nephrotic syndrome was the most common renal syndrome in this group, as in the younger group. Secondary glomerular disease was seen in 26.9% of elderly with a lower risk of lupus nephritis and higher risk of amyloidosis, multiple myeloma, light chain deposition disease and hypertensive nephrosclerosis, compared to younger patients. In patients presented with nephrotic syndrome MG was the most common diagnosis found followed by amyloidosis, FSGS and membranoproliferative glomerulonephritis (MPGN).
Conclusions: Our study showed higher rate of renal biopsy done for older men (65.9%) and nephrotic syndrome was the most common reason for performing renal biopsy in the elderly patients (57.6%) that was similar to the patients <65y (57.4%). MG was the most frequent pathology in the elderly followed by FSGS and amyloidosis. In our study 8% of all renal biopsy cases are from elderly that is less than similar studies. This could be due to limitations on performing renal biopsy in this group. Although our study and others showed most of these diseases are treatable and biopsy indications of elderly patients need to be expanded in our center.
Category: Kidney (does not include tumors)
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 307, Wednesday Afternoon