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Abstract: PO1879

Nephrotic Syndrome from the Age of 65 Years: Epidemiological, Clinical, and Renal Biopsy Data

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Soares, Luana Raposo, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Pantoja, Jose Mariano Soriano, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Jorge, Lectícia, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Woronik, Viktoria, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Dias, Cristiane B., Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
Background

This study aims to evaluate epidemiological, clinical, and renal biopsy data of patients aged 65 or over with nephrotic syndrome, admitted in a University Hospital.

Methods

Retrospective cohort study of renal biopsies performed from 2012 to 2017, considering the age 65 years or over, with diagnosis of nephrotic syndrome, under follow-up at the Nephrology Department of the Hospital das Clínicas of the University of São Paulo.

Results

In these period 103 renal biopsies were performed in patients aged 65 or over, 45 (43.68%) of them were indicated by the diagnosis of nephrotic syndrome. These 45 patients had mean age of 70.60±5.24 years old, 60% male, laboratory data at diagnosis were median serum creatinine of 2.02±1.53 mg/dl, hemoglobin of 11.34±1.41 g/dl, serum albumin of 2.23±0.83 g/dl and proteinuria of 6.95±4.64 g/day. Only minor complications of renal biopsy were observed and occurred in 6.6% of cases. The most frequent histological lesion was Membranous Nephropathy in 13 cases (28.88%), followed by Renal Amyloidosis AL in 9 cases (20%), Focal Segmental Glomerulosclerosis (FSGS) in 8 (17.77%) highlighting that 4 patients had the Collapsing Form, Minimal Change Disease (MCD) occurred in 7 cases (15,55%) and the remaining 8 had others glomerular diseases. In Table 1 has the comparison between patients data according the glomerular disease. [Table]

Conclusion

Renal biopsy was a safe procedure and provided confirmation that Membranous Nephropathy was the most common histological lesion followed by Amyloidosis AL in aged 65 or over. Highlights the Collapsing glomerulopathy founded in 8.88% of the patients none of them associated with HIV or other disease. Minimal Change Disease was the only cause of nephrotic syndrome with acute tubular necrosis in this population, while FSGS had less vascular lesions at renal biopsy.

Comparative data on diagnosis and after 6 months of follow up according glomerular disease.
VariableMembranous
Nephropathy
n = 13
Amyloidosis
n = 9
FSGS
n = 8
MCD
n = 7
P value
Age (years)70.46±4.4672±4.9768.50±4.0374±8.730.33
sCr (mg/dL)
Inicial

Final
1.45±0.84

1.77±0.89
2.30±2.17

5.69±2.29
2.01±0.86

2.75±2.41
1.75±1.23

1.20±0.47
0.36

0.02
Proteinuria (g/day)
Inicial

Final
7.49±4.41

3.03± 0.75
9.14±5.13

24.18±18.53
8.02±3.93

3.99±3.75
8.28±8.14

0.99±1.23
0.77

0.007
Histology
ATN

Vascular lesions

TI fibrosis
0 (0%)

9 (69.2%)

3 (23%)
0 (0%)

9 (100%)

2 (22.2%)
0 (0%)

8 (100%)

3 (37.5%)
3 (42.8%)

7 (100%)

0 (0%)
0.002

0.04

0.37

sCr – serum creatinine; ATN acute tubular necrosis; TI tubules and interstice

Funding

  • Private Foundation Support