title: A clinicopathological study of renal biopsies from 288 elderly patients: analysis based on 4,185 cases.
abstract: OBJECTIVE
  To investigate the clinical characteristics and histopathological features of kidney disease in elderly patients.
  
  
  METHODS
  We retrospectively analyzed the results of 4,185 consecutive renal biopsies, and 288 patients aged >60 years at the Second Hospital of Jilin University from January 1998 to December 2013 were finally included. All patients had been clinically and histologically diagnosed with kidney disease.
  
  
  RESULTS
  Nephrotic syndrome was the main clinical indication for biopsy. Twenty-four patients (8.33 %) experienced a minor complication related to their biopsy procedure. Among patients diagnosed as primary glomerulonephritis (GN), membranous nephropathy (MN) was the most frequent subclassification (24.7 %), followed by mesangioproliferative glomerulonephritis (MsPGN, 11.1 %) and IgA nephropathy (IgAN, 8.0 %). Amyloidosis (8.7 %) was the most common secondary GN, followed by antineutrophil cytoplasmic autoantibody (ANCA)-associated pauci-immune GN (5.2 %) and diabetic nephropathy (DN, 3.8 %). Based on renal biopsies results, 143/288 patients received immunosuppressive therapy and showed an overall remission rate (complete plus partial remissions) of 74.1 %. Among 71 MN patients, 29 patients received steroids plus cyclophosphamide and showed a remission rate of 79.3 %, while 42 patients received steroids and tacrolimus and showed a remission rate of 90.5 %. Among 25 patients with amyloidosis, 22 cases received melphalan plus dexamethasone and showed a remission rate of 40.9 %, while three patients received vincristine, adriamycin, and dexamethasone and showed a remission rate of 66.7 %.
  
  
  CONCLUSIONS
  Making an accurate pathologic diagnosis by renal biopsy is crucial for selecting the proper treatment for elderly patients with kidney disease.
authors.affiliation: The Department of Nephropathy, The Second Hospital, Norman Bethune Medical College, Jilin University, Changchun, 130021, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Wenpeng
authors.initials: W
authors.lastname: Cui
authors.forename: Chunyan
authors.initials: C
authors.lastname: He
authors.forename: Shujun
authors.initials: S
authors.lastname: Liu
authors.forename: Qiaoyan
authors.initials: Q
authors.lastname: Guo
authors.forename: Man
authors.initials: M
authors.lastname: Wu
authors.forename: Lining
authors.initials: L
authors.lastname: Miao
authors.forename: Ping
authors.initials: P
authors.lastname: Luo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000473:pathology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000473:pathology; D001706:Biopsy / Q000009:adverse effects; D003520:Cyclophosphamide / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000473:pathology; D005260:Female; D005922:Glomerulonephritis, IGA / Q000473:pathology; D015432:Glomerulonephritis, Membranoproliferative / Q000473:pathology; D015433:Glomerulonephritis, Membranous / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000473:pathology; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D018906:Antineoplastic Agents, Alkylating; D007166:Immunosuppressive Agents; D003907:Dexamethasone; D003520:Cyclophosphamide; D008558:Melphalan; D016559:Tacrolimus