Clinical impact of renal biopsy on outcomes in elderly patients with nephrotic syndrome.
OBJECTIVE
The number of elderly patients with nephrotic syndrome (NS) is increasing. This study aimed to assess the implications of renal biopsy on the outcomes in elderly patients with NS.


METHODS
Ninety-nine patients diagnosed with NS who were over 60 years of age were reviewed. Secondary NS related to diabetes was excluded. Histopathological diagnosis, comparison of outcomes between the biopsied group (n = 64) and the nonbiopsied group (n = 35) and factors affecting renal survival were evaluated.


RESULTS
The biopsied group was significantly younger and had better renal function than the nonbiopsied group. More patients in the biopsied group than in the nonbiopsied group received immunosuppressive treatment (76.6 vs. 42.9%, p < 0.005), and achieved complete remission (45.3 vs. 26.5%, p = 0.013). The complication rates and renal survival rates were not different between the two groups, but the patient survival rates were significantly higher in the biopsied group (p < 0.005). Predictors for renal survival were renal function at diagnosis and response to treatment.


CONCLUSIONS
Renal biopsy is essential for a correct diagnosis and directed therapeutic approach in elderly patients with NS and may improve the clinical outcomes of these patients.
Yoon
Hye Eun
HE
Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seocho-gu, Seoul, Korea.
Shin
Mi Jung
MJ
Kim
Young Soo
YS
Choi
Bum Soon
BS
Kim
Byung Soo
BS
Choi
Young Jin
YJ
Kim
Young Ok
YO
Yoon
Sun Ae
SA
Kim
Yong Soo
YS
Yang
Chul Woo
CW
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002423:Cause of Death; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000473:pathology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D007166:Immunosuppressive Agents