Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2016 Nov 25;17(1):194.
doi: 10.1186/s12882-016-0410-8.

Kidney disease in the elderly: biopsy based data from 14 renal centers in Poland

Agnieszka Perkowska-Ptasinska  1 , Dominika Deborska-Materkowska  2 , Artur Bartczak  3 , Tomasz Stompor  4 , Tomasz Liberek  5 , Barbara Bullo-Piontecka  5 , Anna Wasinska  6 , Agnieszka Serwacka  6 , Marian Klinger  7 , Jolanta Chyl  8 , Michal Kuriga  9 , Robert Malecki  10 , Krzysztof Marczewski  11 , Bogdan Hryniewicz  12 , Tadeusz Gregorczyk  13 , Monika Wieliczko  14 , Stanislaw Niemczyk  15 , Olga Rostkowska  2 , Leszek Paczek  16 , Magdalena Durlik  2
Affiliations
Multicenter Study

Kidney disease in the elderly: biopsy based data from 14 renal centers in Poland

Agnieszka Perkowska-Ptasinska et al. BMC Nephrol. .

Abstract

Background: Longer life expectancy is associated with an increasing prevalence of kidney disease. Aging itself may cause renal damage, but the spectrum of kidney disorders that affect elderly patients is diverse. Few studies, mostly form US, Asia and West Europe found differences in the prevalence of some types of kidney diseases between elderly and younger patients based on renal biopsy findings, with varied proportion between glomerulopathies and arterionephrosclerosis as a dominant injury found. Here, for the first time in Eastern Europe we analyzed native kidney biopsy findings and their relationship to clinical characteristics at the time of biopsy in elderly individuals (aged ≥65) in comparison to younger adults (aged 18-64).

Methods: Biopsy and clinical data from 352 patients aged ≥65 were retrospectively identified, analyzed and compared with a control group of 2214 individuals aged 18-64. All kidney biopsies studied were examined at Medical University of Warsaw in years 2009-14.

Results: In elderly patients the leading indication for biopsy was nephrotic range proteinuria without hematuria (34.2%) and the most prevalent pathologic diagnoses were: membranous glomerulonephritis (MGN) (18.2%), focal segmental glomerulosclerosis (FSGS) (17.3%) amyloidosis (13.9%) and pauci immune glomerulonephritis (12.8%). Hypertension and age-related lesions very rarely were found an exclusive or dominant finding in a kidney biopsy (1.7%) and a cause of proteinuria (1.1%) in elderly individuals. There were 18.2% diabetics among elderly individuals, and as much as 75% of them had no morphologic signs of diabetic kidney disease in the renal biopsy. Amyloidosis, MGN, pauci immune GN, crescentic GN and light and/or heavy chain deposition disease (LCDD/HCDD) were more frequent whereas IgA nephropathy (IgAN), lupus nephritis (LN) and thin basement membrane disease (TBMD) were less common among elderly than in younger patients.

Conclusions: Proteinuria, a dominating manifestation in elderly patients subjected to kidney biopsy was most commonly related to glomerulopathies. The relatively high prevalence of potentially curative kidney diseases in elderly individuals implicates the importance of renal biopsy in these patients.

Keywords: Glomerulonephritis; Hypertensive nephropathy; Kidney biopsy; Kidney disease in elderly.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Frequency (a) and relative frequency (b) distribution of selected kidney biopsy based diagnoses according to age of disease onset
See this image and copyright information in PMC

References

    1. Hemmelgarn BR, Zhang J, Manns BJ, Tonelli M, Larsen E, Ghali WA, et al. Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int. 2006;9:2155–61. doi: 10.1038/sj.ki.5000270. - DOI - PubMed
    1. Pani A, Bragg-Gresham J, Masala M, Piras D, Atzeni A, Pilia MG, et al. Prevalence of CKD and its relationship to eGFR-related genetic loci and clinical risk factors in the SardiNIA study cohort. J Am Soc Nephrol. 2014;25:1533–44. doi: 10.1681/ASN.2013060591. - DOI - PMC - PubMed
    1. Esposito C, Torreggiani M, Arazzi M, Serpieri N, Scaramuzzi ML, Manini A, Grosjean F, Esposito V, Catucci D, La Porta E, Dal CA. Loss of renal function in the elderly Italians: a physiologic or pathologic process? J Gerontol A Biol Sci Med Sci. 2012;67:1387–93. doi: 10.1093/gerona/gls182. - DOI - PubMed
    1. Heldal K, Hartmann A, Grootendorst DC, de Jager DJ, Leivestad T, Foss A, et al. Benefit of kidney transplantation beyond 70 years of age. Nephrol Dial Transplant. 2010;25:1680–7. doi: 10.1093/ndt/gfp681. - DOI - PMC - PubMed
    1. World Health Organization. Health statistics and information systems. WHO; 2016. http://www.who.int/healthinfo/survey/ageingdefnolder/en/.

Publication types