Abstract: TH-PO121

Clinicopathologic Features of Biopsy-Proven Kidney Diseases in Korean Elderly Patients over 65 Years Old

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Kang, Seong Sik, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Hayeon, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Yeo, Sang Mok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Jin, Kyubok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Sung Bae, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
Background

As the life expectancy increases and the aging society comes, the incidence of kidney disease (KD) is increasing in the elderly population. The purpose of this study was to evaluate the clinical and pathological spectrums of KD in the elderly population.

Methods

We retrospectively investigated 101 patients aged over 65 years with biopsy-proven KD. We analyzed the clinicopathologic manifestation, treatment strategy, and clinical course of KD.

Results

The mean age at the time of kidney biopsy was 71 ± 4 years, and 44.6% of patients had hypertension and 10.9% had diabetes. The median serum creatinine was 1.4 mg/dL (interquartile rage 0.9, 2.3). The most common clinical diagnosis was nephrotic syndrome (NS, 55%), followed by asymptomatic urinary abnormality (AUA, 12%). The most common primary glomerular disease was membranous nephropathy (MN, 33%) and, secondary glomerular disease was anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AGN, 24%). The most common pathologic diagnosis classified based on clinical diagnosis was MN (33%) in NS, IgA nephropathy (IgAN, 33%) in AUA, AGN (67%) in rapidly progressive glomerulonephritis (RPGN), IgAN (88%) in acute nephritic syndrome, and hypertensive nephropathy (25%) in chronic GN. Treatment strategies for KD were angiotensin converting enzyme inhibitor or angiotensin receptor blocker (48%), and immunosuppressants (48%) such as steroid, cyclosporine, mycophenolate mofetil, or cyclophosphamide. The most common disease that was completely responded among NS was minimal change disease (39%). Of the 21 (21%) patients who received dialysis, 11 (52%) received dialysis due to the onset of acute kidney injury (AKI), and received maintenance dialysis without recovery. The most common cause of dialysis was AGN (38%). Death rate was 17%, and the most common cause was infection (53%).

Conclusion

KD in elderly patients showed various patterns in our study. The most common indication for kidney biopsy in elderly patients was NS. NS in elderly patients should be actively performed for kidney biopsy because of the high rate of complete remission when treated. All elderly patients with AKI were dialyzed and progressed to end-stage renal disease without recovery. RPGN in elderly patients should be diagnosed and treated early because the prognosis is poor.