title: Vasculitides with predominantly renal involvement: influence of age on the mode of presentation.
abstract: Vasculitis with predominant renal involvement are increasingly observed in elderly patients. It predominantly involves patients with microscopic polyangiitis, Wegener's granulomatosis, renal limited vasculitis and, in a smaller proportion, Churg Strauss syndrome. The elderly patients present very few obvious symptoms or signs of vasculitis such as hemoptysis and pulmonary infiltrates, and they are often submitted to: 1/renal biopsy when renal failure is already advanced; 2/ have more severe renal disease than do young and middle-aged patients (81% of acute and/or rapidly progressive renal failure versus 62%, and 30% of oliguria versus 6%); and 3/ a worse prognosis compared with younger individuals (probability of survival at 3 months, 1 year and 5 years of 93%, 93% and 92% in patients under 65, versus 67%, 62% and 46% in the elderly). Management of all patients with vasculitis and predominant renal involvement requires a quick diagnosis and immunosuppressive treatment aimed at controlling the disease. Treatment is mantained for 18 to 24 months. Nevertheless, relapses do occur (between 20% to 52%) of all patients with microscopic polyangiitis and Wegener's granulomatosis.
authors.affiliation: Servicio de Nefrologia, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Serra
authors.forename: R
authors.initials: R
authors.lastname: Romero
mesh_terms: D000367:Age Factors; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012008:Recurrence; D013997:Time Factors; D014657:Vasculitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy