Kidney biopsy in elderly patients

Abstract

Background Although there is progressive loss of renal mass and function as age progresses, still newer kidney diseases occur. Kidney diseases in the elderly are different compared with younger population. This is because of more commoner occurrence of secondary kidney diseases than primary kidney diseases compared with younger. There is a paucity of Indian literature regarding kidney biopsy in the elderly. The reasons could be fear of increased risk of complications in the elderly, or attributing all kidney diseases to common comorbidities like diabetes mellitus, hypertension, malignancy, intake of potential nephrotoxic medications, and not subjecting them to kidney biopsy. Thus, performing kidney biopsies and analyzing the biopsy findings is not only important for diagnosis of potentially curable kidney diseases, but also guides the therapy. Patients and methods It was a retrospective observational study conducted to assess the clinical profile and histopathological spectrum in elderly patients who underwent kidney biopsies. Results The most common indication of kidney biopsy was nephrotic syndrome. The commonest histological finding was membranous nephropathy. Compared with the elderly group, the frequency of lupus nephritis, focal segmental glomerulosclerosis, minimal change disease, IgA nephropathy, and acute tubular necrosis was significantly more in younger age. Conclusions The most common indication for kidney biopsy in the elderly was nephrotic syndrome. Membranous nephropathy was the commonest histologic finding. The results obtained in this study could add to previous studies to give valuable information of kidney diseases in the elderly. Kidney biopsy is useful in diagnosing many treatable kidney diseases in the elderly and prevents unwanted exposure to empirical immunosuppression.