title: Pattern of biopsy-proven kidney disease in the elderly in a tertiary care hospital in India: a clinicopathological study.
abstract: BACKGROUND
  An aging population is an important demographic issue in India. The knowledge base about kidney diseases among the elderly Indians is inadequate. We aim to delineate the clinical profile and spectrum of biopsy-proven kidney disease in elderly patients.
  
  
  METHODS
  Records of all elderly patients (≥60 years) who had undergone kidney biopsy in the nephrology department from January 2010 to December 2014 were reviewed. Their clinical details and laboratory investigations at the time of biopsy were noted. Details of kidney biopsy were recorded from their biopsy reports.
  
  
  RESULTS
  In total, 1728 patients underwent kidney biopsy during this period and 124 were elderly (7.2%). Their mean age was 64.9 ± 4.9 years, and they were predominantly males (63.7%). Mean serum creatinine was 3.0 ± 2.8 mg/dl, proteinuria was 4.0 ± 2.7 g/day, and 39.5% had microscopic hematuria. The most common indications for biopsy were nephrotic syndrome (NS)--39.5% and acute kidney injury/rapidly progressive glomerulonephritis (AKI/RPGN)--24.2%. Another 8.1% patients had NS with AKI. MN (39.0%) was the chief cause of NS, and pauci-immune crescentic glomerulonephritis (GN) (28.2%) was the leading cause of AKI/RPGN. MN, pauci-immune crescentic GN and acute on chronic tubulointerstitial nephritis (A/CTIN) and acute tubular injury (ATI) were more common in the elderly, while MCD, FSGS, IgA nephropathy and lupus nephritis were more frequent in the younger patients. 68.5% of the elderly patients biopsied were diagnosed with a renal disease which was potentially amenable to specific treatment.
  
  
  CONCLUSIONS
  The spectrum of biopsy-proven kidney disease in the elderly Indians seen in our tertiary care hospital varies from the younger population. Kidney biopsy provides useful information with therapeutic and prognostic implications in these patients. The percentage of elderly patients among the total biopsied population is low in India, and these patients present late with renal dysfunction. Prospective studies are needed to assess the outcome of the commonly seen kidney diseases in elderly patients.
authors.affiliation: Department of Nephrology, All India Institute of Medical Sciences, New Delhi, 110029, India. soumita_bagchi@yahoo.co.in.
authors.forename: Soumita
authors.initials: S
authors.lastname: Bagchi
authors.affiliation: Department of Nephrology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Parmod
authors.initials: P
authors.lastname: Mittal
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Geetika
authors.initials: G
authors.lastname: Singh
authors.affiliation: Department of Nephrology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Agarwal
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Lavleen
authors.initials: L
authors.lastname: Singh
authors.affiliation: Department of Nephrology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Dipankar
authors.initials: D
authors.lastname: Bhowmik
authors.affiliation: Department of Nephrology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mahajan
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Dinda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013997:Time Factors
keywords: Elderly; India; Kidney biopsy