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Abstract: SA-PO722

Histological and Clinical Patterns in Glomerular Diseases of the Elderly: A Monocentric Study

Session Information

  • Geriatric Nephrology
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Angioi, Andrea, Ospedale Brotzu, Cagliari, Italy
  • Lepori, Nicola, Ospedale Brotzu, Cagliari, Italy
  • Floris, Matteo, Ospedale Brotzu, Cagliari, Italy
  • Cao, Riccardo, Ospedale Brotzu, Cagliari, Italy
  • Asunis, Anna Maria, Ospedale Brotzu, Cagliari, Italy
  • Cabiddu, Gianfranca, Ospedale Brotzu, Cagliari, Italy
  • Pani, Antonello, Ospedale Brotzu, Cagliari, Italy
Background

Renal biopsy is an essential instrument for diagnosis of glomerular disease: according to data described in literature, this tool is overlooked in the elderly patients, which represent 15% of renal biopsies

Methods

Our Division is the regional hub of renal diseases in Sardinia, covering around 1.6 million of inhabitants, of whom 217.000 are eldery. We retrospectively reviewed histological and clinical data of all biopsy proven glomerular disease performed on >65 y/o patients from 2000 to 2016.

Results

227 patients, with a mean age of 73.62 + 6.41 years, were included in our analysis. 61.2% of them were younger than 75 y/o and 3.5% were older than 85 y/o (with 3 patients > 99 y/o). The annual incidence of biopsy proven glomerular diseases in the elderly population increased progressively in the considered period, from 4 cases/100.000 exposed in 2000 to 11.5 cases/100.000 in 2016. Membranous Nephropathy was the most recurrent histological diagnosis (23.8%), followed by Minimal Change Disease (13.2%), AL amyloidosis (9.3%) and MPO-ANCA vasculitis (9.3%). Our analysis showed few significative differences when patients were classified according their age (65-74, 75-84 and >85 years old): diabetic nephropathy was more frequent in the third group (p 0.001) and MPO-ANCA vasculitis were more frequently diagnosed in group 1 and 2 than in group 3 (p 0.05). Interestingly, incidence of MGRS and malignant clones with renal involvement rose from no cases in 2000-2003, to a peak of 33% in 2013

Conclusion

Incidence of glomerular diseases is increasing, likely due to more comprehensive indications to renal biopsy from 2000 to 2016. Histological patterns revealed a substantial homogeneity in among the three subgroups analyzed. Coherently, most of patients benefited of a specific treatment. Renal biopsy is, therefore, an irreplaceable tool even in a selected elderly population

Annual number of new biopsy proven diagnosis of glomerular disease in elderly patients at Ospedale Brotzu Nephrology Department (2000-2016)