Biopsy-proven kidney diseases in the elderly: clinical characteristics, renal histopathological spectrum and prognostic factors

Chen, Yue; Li, Ping; Cui, Chunli; Yuan, Ai-Hong; Kun, Zhang; Chen, Yu

doi:10.1177/0300060516660247

Cited by 14 publications

(13 citation statements)

References 24 publications

(40 reference statements)

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“…Young adult patients (15–49 years) were the most prevalent patients with glomerular disease in our study, accounting for 52.3%. The proportion of elderly patients (≥60 years) in our study was 26.6%, which is much higher than the percentage of the elderly patients among all renal biopsy patients reported by Shanghai Tongji Hospital (17.1%) [13]. Elderly individuals are more susceptible to kidney damage because glomeruli become sclerotic and the glomerular filtration rate declines with age.…”

Section: Discussioncontrasting

confidence: 53%

Pathological spectrum of glomerular disease in patients with renal insufficiency: a single-center study in Northeastern China

et al. 2019

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Background: To investigate the pathological spectrum of glomerular disease in patients with renal insufficiency (RI) from 2008 to 2017. Methods and results: We calculated the estimated glomerular filtration rate (eGFR) with the Chronic Kidney Disease Epidemiology Collaboration creatinine (CKD-EPI) equation and defined RI as an eGFR <60 ml/min/1.73 m 2 . A total of 969 RI patients were included in our study. IgA nephropathy (IgAN) was the most common subtype of primary glomerulonephritis (37.2%). The frequencies of IgAN and non-IgA mesangioproliferative glomerulonephritis decreased from 27.3% and 9.5% during 2008-2012 to 20.7% and 2.6% during 2013-2017, respectively. However, the frequency of membranous nephropathy increased from 6.8% to 16.2%. Lupus nephritis was the most common subtype of secondary glomerulonephritis (32.1%). The frequencies of both ANCA-associated systemic vasculitis and diabetic nephropathy increased from 3.8% to 7.6% and from 4.3% to 7.6%, respectively. The number of elderly patients (!60 years) in our study increased sharply, from 15.6% in 2008 to 35.0% in 2017. Membranous nephropathy, minimal change disease, membranoproliferative glomerulonephritis, lupus nephritis and renal amyloidosis are more frequently observed in the elderly patients than in nonelderly patients (<60 years) (p < .05). Excluding those with acute kidney injury, IgAN was the leading cause of RI (24.9%), followed by membranous nephropathy (13.3%) and lupus nephritis (12.0%). Conclusions: IgAN and lupus nephritis were the most prevalent primary glomerulonephritis and secondary glomerulonephritis in patients with RI, respectively. The frequencies of membranous nephropathy, ANCA-associated systemic vasculitis and diabetic nephropathy increased significantly. The number of elderly patients with RI increased sharply. ARTICLE HISTORY

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Section: Discussioncontrasting

confidence: 53%

Pathological spectrum of glomerular disease in patients with renal insufficiency: a single-center study in Northeastern China

et al. 2019

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“…With the improvement of people's living conditions, the incidence of DN has significantly risen in elderly patients in recent years compared to previous findings [15]. Chen et al [27] and Zhu et al [20] reported SVARD as the most common SGN in elderly patients. In our study, the prevalence rate of SVARD was 4.8%, second only to DN (5.1%).…”

Section: Discussionmentioning

confidence: 74%

“…This was consistent with our study findings, as PGN was diagnosed in 70.8% of the elderly patients; however, the incidence of PGN was significantly lower in the elderly than that in the non-elderly patients. It is reported that the incidence rate of MN is on the rise [ 26 ] and MN is the most common pathological type of PGN in elderly patients in China [ 13 , 20 , 27 , 28 ], India [ 29 ], and Poland [ 30 ]. This was consistent with our study findings as the most common PGN was MN, followed by MCD and IgAN.…”

Section: Discussionmentioning

confidence: 99%

Clinical and pathological analysis of renal biopsies of elderly patients in Northeast China: a single-center study

et al. 2021

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Purpose: To identify the clinical characteristics, histopathological features, and prognosis of kidney disease in a large cohort of elderly patients from Northeast China. Methods: We retrospectively analyzed the renal disease spectrum in 7,122 patients who underwent renal biopsies at the Second Hospital of Jilin University from 2006 to 2020. Patients were grouped according to age: below 60 years (non-elderly group, n ¼ 5923) and at least 60 years (elderly group, n ¼ 1199). The clinical and pathological characteristics of renal biopsy patients in the groups were analyzed using the t-test and chi-square test. Results: Compared with the non-elderly group, the elderly group had significantly fewer patients with primary glomerulonephritis, but more patients with tubulointerstitial disorders (p < .05). The incidence of IgA nephropathy, mesangial proliferative glomerulonephritis, and lupus nephritis was significantly lower in elderly patients than in non-elderly patients. The incidence of membranous nephropathy, membranoproliferative glomerulonephritis, diabetic nephropathy, hypertensive nephropathy, systemic vasculitis-associated renal damage, and amyloid nephropathy was significantly higher in elderly patients than in non-elderly patients (p < .05). The incidence of perinephric hematoma (!4 cm 2 ) in elderly patients with renal biopsy was lower than that in non-elderly patients. We noted that 79.9% of primary glomerulonephritis patients who received immunosuppressive therapy showed a remission rate of 83.5%. Conclusion:The spectrum of kidney disease in the elderly is different from that in the younger population.

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“…Some studies showed that the most common pathological type of kidney disease in the elderly was MN [26–29] and that the incidence of MN has increased over time [4–7, 9, 21]. In contrast, the prevalence of MN decreased over time in the United Kingdom [12] and Japan [30].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Pathological Analysis of 4910 Patients Who Received Renal Biopsies at a Single Center in Northeast China

Nie

Chen

Luo

et al. 2019

BioMed Research International

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Purpose. To identify the epidemiology and pathological types of kidney diseases and their changes during the past decade, in a population from Northeast China. Methods. We retrospectively analysed clinical and renal pathological data from 4910 patients who received renal biopsies in the Second Hospital of Jilin University from 2008 to 2017. Results. Males received more renal biopsies than females (p < 0.001). The average age (p < 0.001) and percentage of elderly patients (p < 0.001) increased over time. The pathological types were primary glomerulonephritis (PGN, 73.2%), secondary glomerulonephritis (SGN, 23.7%), tubular-interstitial nephropathy (TIN, 2.8%), and hereditary nephropathy (HN, 0.3%). The most common forms of PGN were membranous nephropathy (MN, 37.2%) and IgA nephropathy (IgAN, 29.9%). Over time, the prevalence of IgAN decreased, but the prevalence of MN increased. MN was more common in middle-aged and elderly patients, but IgAN was most common in young adults. Analysis of SGN data indicated that lupus nephritis (LN, 34.0%), Henoch-Schönlein purpura glomerulonephritis (HSPN, 17.9%), and diabetic nephropathy (DN, 11.7%) were the most common forms. Over time, the prevalence of DN (p = 0.003), hypertension-associated renal damage (p = 0.005), and systemic vasculitis-associated nephritis (SVARD, p < 0.001) increased, but the prevalence of HSPN (p < 0.001) and hepatitis B virus-associated glomerulonephritis (HBV-GN, p = 0.001) decreased. Nephrotic syndrome was the main clinical manifestation of PGN. Conclusion. From 2008 to 2017, renal biopsies were increasingly performed in the elderly. There were notable changes in the epidemiology and pathological types of kidney disease among renal biopsy patients at our centre.

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Biopsy-proven kidney diseases in the elderly: clinical characteristics, renal histopathological spectrum and prognostic factors

Cited by 14 publications

References 24 publications

Pathological spectrum of glomerular disease in patients with renal insufficiency: a single-center study in Northeastern China

Pathological spectrum of glomerular disease in patients with renal insufficiency: a single-center study in Northeastern China

Clinical and pathological analysis of renal biopsies of elderly patients in Northeast China: a single-center study

Clinical and Pathological Analysis of 4910 Patients Who Received Renal Biopsies at a Single Center in Northeast China

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