Biopsy-proven kidney diseases in the elderly: clinical characteristics, renal histopathological spectrum and prognostic factors

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.