Razionale

The global increase in life expectancy has translated to more elderly patients affected from renal diseases. The role of renal biopsy (RB) in this subset of patients has never been explored; moreover the histological patterns of renal disease in elderly have rarely been described.

Casistica e Metodi

This is a retrospective study of all consecutive elderly patients (age ≥ 70 years) biopsied at S.Orsola-Malpighi Hospital of Bologna between 1st January 2000 and 31 December 2012. Data are extracted from renal biopsies database.

Risultati

No RB has been performed until 2005. 106 (M59, F47) elderly patients have been biopsied in the remnant study period (figure 1). The mean age was 76±4years without difference between sexes. In 8/108 (7.4%) RB was not adequate. Primary glomerulonephritis were seen in 39/100 patients and secondary glomerulonephritis in 25/100. Membranous glomerulonephritis (MGN) was the most common (21/100) and was significantly more frequent in males (M17: F4, p<0.05). Other common diagnoses included cast nephropathy (11/100) and amyloidosis (11/100) (Table 1). Nephrotic syndrome was the most common clinical presentation (43%) followed by acute renal failure (30%). After biopsy, 48% received immunosuppressive therapy.  

Table 1. Histological diagnosis

Conclusioni

Renal biopsy, even in elderly patients, provides us with useful information for an accurate histological diagnosis and, interestingly, ESRD is not very common. In our study, GNM is the most common diagnosis followed by mieloma-related kidney diseases.