title: Renal biopsy in patients over 75: 131 cases.
abstract: BACKGROUND
  Demographic analysis shows the ageing of the global population and the consequent increase in the age of hospitalized subjects and of patients starting dialysis. Hence, interest in the feasibility, safety, and usefulness of renal biopsy in elderly patients is growing. We examined the data of 131 patients over the age of 75 who underwent renal biopsy. We analyzed the safety of the procedure, treatment, and outcomes.
  
  
  RESULTS
  Histological diagnoses included: membranous glomerulonephritis (GN) 20.6%, crescentic GN 12.9%, IgAGN 10.6%, focal segmental glomerulosclerosis 9.1%, acute GN 4.5%, amyloidosis 9.1%, and acute tubular necrosis 3.8%. Mean glomerular obsolescence was 28.9 Â ± 27.9%. Mean age of the patients was 78.7 Â ± 5.73 years. At the time of biopsy, serum creatinine (SCr) was 4.47 Â ± 2.56 mg/dL and proteinuria was 4.82 Â ± 6.78 g/day. Targeted treatment was given to 51.9% of patients, 52.9% of whom had a good clinical response. Eight patients had clinically non-relevant side effects (11.7%). A positive response (defined as a more than 50% reduction of SCr, or by partial or complete remission of proteinuria) was observed in 36 patients (52.9%). 76 patients were monitored for 57 Â ± 9.89 months: 18 patients were on dialysis (follow-up 2.56 Â ± 3.61 months), 15 died (follow-up 58.5 Â ± 13.43 months), and 52 remained under nephrologic observation for 36 Â ± 31 months (SCr was 2.56 Â ± 0.75 mg/dL and proteinuria was 4.82 Â ± 6.78 g/day).
  
  
  CONCLUSIONS
  In our experience, renal biopsy is safe even in very elderly patients; it allowed targeted treatment in 51.9% of patients, 52.9% of whom had a good clinical response, possibly contributing to prolonged patient survival and improved quality of life.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Rollino
authors.forename: Michela
authors.initials: M
authors.lastname: Ferro
authors.forename: Giulietta
authors.initials: G
authors.lastname: Beltrame
authors.forename: Giacomo
authors.initials: G
authors.lastname: Quattrocchio
authors.forename: Carlo
authors.initials: C
authors.lastname: Massara
authors.forename: Francesco
authors.initials: F
authors.lastname: Quarello
authors.forename: Dario
authors.initials: D
authors.lastname: Roccatello
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000188:drug therapy / Q000473:pathology; D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000188:drug therapy / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000188:drug therapy / Q000473:pathology; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy / Q000473:pathology; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy / Q000473:pathology; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000188:drug therapy / Q000473:pathology*; D007683:Kidney Tubular Necrosis, Acute / Q000188:drug therapy / Q000473:pathology; D008297:Male; D061214:Patient Safety; D011507:Proteinuria / Q000652:urine; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D003404:Creatinine