title: Renal biopsy in the very elderly.
abstract: OBJECTIVE
  Data regarding renal biopsy in the very elderly (>or=age 80 yr) are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in very elderly patients who underwent native renal biopsy.
  
  
  METHODS
  All native renal biopsies (n = 235 including 106 men, 129 women) performed in patients aged >or=80 yr over a 3.67-yr period were retrospectively identified. Results were compared with a control group of 264 patients aged 60 to 61 who were biopsied over the same period.
  
  
  RESULTS
  The indications for biopsy were acute kidney injury (AKI) in 46.4%, chronic-progressive kidney injury in 23.8%, nephrotic syndrome (NS) in 13.2%, NS with AKI in 9.4%, and isolated proteinuria in 5.5%. Pauci-immune GN was the most frequent diagnosis (19%), followed by focal segmental glomerulosclerosis secondary to hypertension (7.6%), hypertensive nephrosclerosis (7.1%), IgA nephropathy (7.1%) and membranous nephropathy (7.1%). Comparison with the control group showed pauci-immune GN to be more frequent (P < 0.001) and diabetic glomerulosclerosis (P < 0.001) and membranous nephropathy (P < 0.05) less frequent in the very elderly. Diagnostic information had the potential to modify treatment in 67% of biopsies from the very elderly, particularly in those with AKI or NS.
  
  
  CONCLUSIONS
  Renal biopsy in very elderly patients is a valuable diagnostic tool that should be offered in clinical settings with maximal potential benefit. Advanced age per se should no longer be considered a contraindication to renal biopsy.
authors.affiliation: Department of Nephrology, Evangelismos General Hospital, Athens, Greece.
authors.forename: Dimitrios-Anestis
authors.initials: DA
authors.lastname: Moutzouris
authors.forename: Leal
authors.initials: L
authors.lastname: Herlitz
authors.forename: Gerald B
authors.initials: GB
authors.lastname: Appel
authors.forename: Glen S
authors.initials: GS
authors.lastname: Markowitz
authors.forename: Bernard
authors.initials: B
authors.lastname: Freudenthal
authors.forename: Jai
authors.initials: J
authors.lastname: Radhakrishnan
authors.forename: Vivette D
authors.initials: VD
authors.lastname: D'Agati
mesh_terms: D055371:Acute Lung Injury / Q000473:pathology; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006417:Hematuria / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000473:pathology*; D008297:Male; D009404:Nephrotic Syndrome / Q000473:pathology; D011379:Prognosis; D011507:Proteinuria / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000473:pathology; D012189:Retrospective Studies