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Kidney Week

Abstract: TH-PO660

Kidney Biopsy in Elderly Chinese Patients

Session Information

  • Geriatric Nephrology
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Xiong, Mengqi, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • Nie, Sheng, Nanfang Hospital, Southern Medical University, Guangzhou, GUANGDONG, China
  • Wang, Long, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • Dong, Jin, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • Xu, Xin, Renal Division, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease, Guangzhou, China
Background

High-quality epidemiologic data on the spectrum of biopsy-proven kidney diseases among elderly patients are limited in China. This study aimed to examine the clinical characteristics and spectrum of kidney diseases in elderly patients who underwent native kidney biopsy.

Methods

We previously conducted a nationwide kidney biopsy survey including 178,803 patients from January 2002 to April 2018. A total of 10,597 native kidney biopsy performed in patients aged ≥65 years from 1590 hospitals across China were included in this study. The composition of kidney diseases and clinicopathologic correlations in different sexes, age groups, different period and regions were assessed.

Results

The most common indication for kidney biopsy in elderly patients was nephrotic syndrome (62.1%). Membranous nephropathy (MN) was the most frequent histological type (48.8%), followed by minimal change disease (9.8%) and IgA nephropathy (8.0%). We observed a increasing trend in the proportion of MN over the study period which was contemporaneous with a fall in the proportion of focal segmental glomerulosclerosis. There was no significant difference in major glomerular diseases between patients aged 65-79 years and ≥80 years after adjusting for sex, region, indication of biopsy, the level of the hospital that performed the biopsy and the time of kidney biopsy. Our study showed that the proportion of non-diabetic kidney disease (NDKD) is up to 62.7% in elderly diabetic patients underwent kidney biopsy, and the most common type of NDKD was MN. Compared with the patients aged 18-64 years underwent kidney biopsy over the same period, the proportion of renal artery injury (65.4% vs. 92.5%, p<0.001) was significantly higher, while phospholipase A2 receptor-positive MN (80% vs. 63.4%, p<0.05) was significantly lower in the very elderly patients (age≥80 years).

Conclusion

The spectrum of kidney diseases among elderly Chinese patients varied across sexes, age groups and regions and changed substantially from 2002 to 2018.

Renal biopsy diagnoses by clinical syndrome in the elderly
NS n(%)Proteinuria (without NS) n(%)CKD n(%)AKI n(%)NS+AKI n(%)Hematuria n(%)
MN 4250(63.6)MN 862(36.1)IgAN 198(19.4)AAV 81(22.1)MCD 113(34.9)MsPGN 15(34.9)
MCD 862(12.9)IgAN 352(14.8)DKD 111(10.9)ATIN 71(19.4)MN 59(18.2)IgAN 13(30.2)
Amyloidosis 321(4.8)MsPGN 243(10.2)AAV 109(10.7)ATN 33(9)FSGS 44(13.6)TBMN 3(7)

MsPGN, mesangial proliferative glomerulopathy; DKD, diabetic kidney disease; AAV, ANCA-associated vasculitis; ATIN, acute tubulointerstitial nephropathy.