title: Kidney disease in the elderly: biopsy based data from 14 renal centers in Poland.
abstract: Longer life expectancy is associated with an increasing prevalence of kidney disease. Aging itself may cause renal damage, but the spectrum of kidney disorders that affect elderly patients is diverse. Few studies, mostly form US, Asia and West Europe found differences in the prevalence of some types of kidney diseases between elderly and younger patients based on renal biopsy findings, with varied proportion between glomerulopathies and arterionephrosclerosis as a dominant injury found. Here, for the first time in Eastern Europe we analyzed native kidney biopsy findings and their relationship to clinical characteristics at the time of biopsy in elderly individuals (aged ≥65) in comparison to younger adults (aged 18-64).
  
  
  
  Biopsy and clinical data from 352 patients aged ≥65 were retrospectively identified, analyzed and compared with a control group of 2214 individuals aged 18-64. All kidney biopsies studied were examined at Medical University of Warsaw in years 2009-14.
  
  
  
  In elderly patients the leading indication for biopsy was nephrotic range proteinuria without hematuria (34.2%) and the most prevalent pathologic diagnoses were: membranous glomerulonephritis (MGN) (18.2%), focal segmental glomerulosclerosis (FSGS) (17.3%) amyloidosis (13.9%) and pauci immune glomerulonephritis (12.8%). Hypertension and age-related lesions very rarely were found an exclusive or dominant finding in a kidney biopsy (1.7%) and a cause of proteinuria (1.1%) in elderly individuals. There were 18.2% diabetics among elderly individuals, and as much as 75% of them had no morphologic signs of diabetic kidney disease in the renal biopsy. Amyloidosis, MGN, pauci immune GN, crescentic GN and light and/or heavy chain deposition disease (LCDD/HCDD) were more frequent whereas IgA nephropathy (IgAN), lupus nephritis (LN) and thin basement membrane disease (TBMD) were less common among elderly than in younger patients.
  
  
  
  Proteinuria, a dominating manifestation in elderly patients subjected to kidney biopsy was most commonly related to glomerulopathies. The relatively high prevalence of potentially curative kidney diseases in elderly individuals implicates the importance of renal biopsy in these patients.
authors.affiliation: Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Transplantation Institute, Warsaw, 02-006, Poland. aggape@poczta.onet.pl.
authors.forename: Agnieszka
authors.identifier: 0000-0001-5524-3534
authors.initials: A
authors.lastname: Perkowska-Ptasinska
authors.affiliation: Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Transplantation Institute, Warsaw, 02-006, Poland.
authors.forename: Dominika
authors.initials: D
authors.lastname: Deborska-Materkowska
authors.affiliation: Department of Pathology, The Medical Center of Postgraduate Education, Warsaw, 01-813, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Bartczak
authors.affiliation: Department of Nephrology, Hypertension and Internal Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, 10-561, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stompor
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, 80-211, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Liberek
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, 80-211, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bullo-Piontecka
authors.affiliation: Department of Internal Diseases, Nephrology and Transplantology, Central Clinical Hospital of the Ministry of Interior, Warsaw, 02-507, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Wasinska
authors.affiliation: Department of Internal Diseases, Nephrology and Transplantology, Central Clinical Hospital of the Ministry of Interior, Warsaw, 02-507, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Serwacka
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, 50-556, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
authors.affiliation: Dialysis Unit, Specialist Hospital in Radom, Radom, 26-600, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Chyl
authors.affiliation: Department of Nephrology, District Hospital in Plock, Plock, 09-400, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Kuriga
authors.affiliation: Department of Internal Medicine and Nephrology, Specialist Hospital in Miedzylesie, Warszawa, 04-749, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Malecki
authors.affiliation: Department of Nephrology, Endocrinology, Hypertension and Internal Diseases, Public District Hospital in Zamosc, Zamosc, 22-410, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Marczewski
authors.affiliation: Department of Nephrology and Dialysis, District Specialist Hospital in Slupsk, Slupsk, 76-200, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Hryniewicz
authors.affiliation: Department of Nephrology, District Hospital in Kielce, Kielce, 75-736, Poland.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Gregorczyk
authors.affiliation: Department of Nephrology, Dialysis, and Internal Diseases, Medical University of Warsaw, Warsaw, 02-097, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Wieliczko
authors.affiliation: Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, 04-141, Poland.
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Niemczyk
authors.affiliation: Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Transplantation Institute, Warsaw, 02-006, Poland.
authors.forename: Olga
authors.initials: O
authors.lastname: Rostkowska
authors.affiliation: Department of Immunology, Transplantology and Internal Medicine, Medical University of Warsaw, Transplantation Institute, Warsaw, 02-006, Poland.
authors.forename: Leszek
authors.initials: L
authors.lastname: Paczek
authors.affiliation: Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Transplantation Institute, Warsaw, 02-006, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Durlik
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Glomerulonephritis; Hypertensive nephropathy; Kidney biopsy; Kidney disease in elderly