Kidney diseases among the elderly--a clinicopathological analysis of 247 elderly patients

Abstract

We describe the clinicopathological features of 247 patients over the age of 60 with renal disorders. We acceded the histological classification of WHO recommendation, except for IgA nephropathy as primary glomerulonephritis. All nephrotic patients other than those with diabetic glomerulosclerosis (DGS) or amyloidosis were treated with steroids and/or immunosuppressants. Clinical data showed 88 patients with nephrotic syndrome. The histological study revealed that 142 patients had primary renal diseases and 105 patients had secondary renal diseases. Of 88 nephrotic patients, 35 were membranous nephropathy (MN) and 9 were minimal change nephrotic syndrome (MCNS). In secondary nephrosis, amyloidosis and DGS were diagnosed in 9 and 7 patients, respectively. A good response to therapy was obtained in MN (89%) and MCNS (78%). However, nephrotic patients with mesangial proliferative glomerulonephritis, amyloidosis, or DGS had unfavorable outcomes. Histological observations are useful aids in estimating the prognosis and therapy selection for renal disorders even in elderly patients.