Renal biopsy in elderly patients: clinicopathological correlation in 117 Korean patients.
OBJECTIVE
In the elderly with renal disease, the clinical presentations are frequently inconsistent with the pathologic findings. We tried to clarify the differences in pathological findings between the young and the elderly, in Korea and in Western countries, and the usefulness of a percutaneous renal biopsy in the elderly with renal disease.


METHODS
We analyzed the clinical presentations and spectrums of renal histopathology by reviewing medical records and renal biopsy reports retrospectively in 117 Korean patients aged 60 years or more with renal disease.


RESULTS
85 patients had primary renal disease. The remaining 32 patients had renal diseases associated with systemic conditions. Out of the 85 patients with primary renal disease, 61 cases presented as idiopathic nephrotic syndrome. Compared with renal biopsy results of younger adult patients (age 15-59, n = 1,908), membranous nephropathy, crescentic glomerulonephritis, membranoproliferative glomerulonephritis, amyloidosis, light chain disease, and thrombotic thrombocytopenic purpura were more prevalent, but IgA nephropathy and lupus nephritis were less common in the elderly patients. In clinical presentation, nephrotic syndrome and rapidly progressive renal failure were more prevalent, but asymptomatic urinary abnormality was less common in elderly patients. The responsiveness to treatment was good in elderly patients with minimal-change lesion (complete remission in all patients) but poor in crescentic glomerulonephritis, IgA nephropathy, and membranoproliferative glomerulonephritis. From the above findings, the clinical presentation, patterns of histopathology and responsiveness to treatment of elderly Korean patients were similar to those of the younger Korean control group and the Western elderly group.


CONCLUSIONS
Percutaneous renal biopsy is a useful diagnostic aid and can be used as a therapeutic guideline even in elderly patients with renal disease.
Shin
J H
JH
Department of Internal Medicine, Guro Hospital, Korea University, Seoul.
Pyo
H J
HJ
Kwon
Y J
YJ
Chang
M K
MK
Kim
H K
HK
Won
N H
NH
Lee
H S
HS
Oh
K H
KH
Ahn
C
C
Kim
S
S
Lee
J S
JS
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001706:Biopsy / Q000379:methods; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
D007166:Immunosuppressive Agents