title: Histopathological findings in elderly patients.
abstract: BACKGROUND
  The elderly population has significantly increased worldwide and recent studies have evidenced a 10-year increase in Brazilian life expectancy. Similarly to other comorbidities, glomerular diseases are also observed in the elderly, and, in that age group, kidney biopsy emerges as a fundamental diagnostic tool to help disease management, preventing unnecessary therapies.
  
  
  OBJECTIVE
  To establish the frequency of histological diagnoses in the elderly undergoing kidney biopsy, with an emphasis on glomerulopathies (GPs), at two Brazilian universities.
  
  
  METHODS
  Retrospective assessment of kidney biopsy reports of the Department of Pathology of UNIFESP (patients aged 60 years or above, from 01/01/1996 to 12/31/2003) and of the outpatient clinic of GPs of NIEPEN. The studies of transplanted kidneys and nephrectomies were excluded. The following data were analyzed: age; sex; clinical syndrome at presentation; and histological diagnosis (light microscopy and immunofluorescence). Nephropathies were classified as primary GPs, secondary kidney diseases, nonglomerular diseases, and others.
  
  
  RESULTS
  One hundred and thirteen biopsies were assessed, the mean age of patients was 66.0 ± 6.0 years, and the male sex prevailed (54.8%). The most common clinical presentation was nephrotic syndrome (32.7%), followed by acute and chronic kidney failure (18.6%, each). Glomerular diseases were as follows: membranous nephropathy (MN), 15%; hypertensive nephrosclerosis, 11.5%; focal segmental glomerulosclerosis and vasculitis/crescentic GN, 9.7% each; amyloidosis, chronic glomerulonephritis, and minimal change disease, 7.1% each; diffuse proliferative GN, 4.4%; IgA nephropathy and lupus nephritis, 2.7% each. Primary GPs predominated (45.2%) as compared with other nephropathies.
  
  
  CONCLUSIONS
  Nephrotic syndrome was the major indication for kidney biopsy. Regarding the kidney histological diagnoses, glomerular diseases predominated, in particular MN and hypertensive nephrosclerosis, findings compatible with previous studies in the area, but rarely assessed among us. It is clear that the diversity of diagnoses and differentiated treatments justify kidney biopsy for decision making in that group of patients.
authors.affiliation: Fundação IMEPEN, Brazil. pvcarmo@gmail.com
authors.forename: Priscylla Aparecida Vieira do
authors.initials: PA
authors.lastname: Carmo
authors.forename: Gianna Mastroianni
authors.initials: GM
authors.lastname: Kirsztajn
authors.forename: Wander Barros do
authors.initials: WB
authors.lastname: Carmo
authors.forename: Marcello Fabiano
authors.initials: MF
authors.lastname: Franco
authors.forename: Marcus Gomes
authors.initials: MG
authors.lastname: Bastos
mesh_terms: D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000473:pathology*; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies