Investigation of the safety and usefulness of a renal biopsy for older elderly patients ≥75 years old

Fukunaga, Shohei; Hoshino, Yuki; Ooba, Masafumi; Kawanishi, Miharu; Yoshikane, Kaori; Egawa, Masahiro; Ito, Takafumi; Tanabe, Kazuaki

doi:10.3143/geriatrics.58.453

Cited by 1 publication

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“…In the contrary, repeat renal biopsy could not only assess progression or severity of existing renal involvement, but also detect potentially new lesions. In addition, with the guidance of ultrasound, renal biopsy is relatively safe in patients without high risk of bleeding [24,25]. Pathologic results can help us carefully balance between the benefits and risks of continuing chemotherapy, thus protect patients from unnecessary adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Value of repeat renal biopsy in the evaluation of AL amyloidosis patients lacking renal response despite of complete hematologic remission: a case report and literature review

et al. 2022

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Backgrounds Published literatures on repeat renal biopsy of AL amyloidosis have basically reached a consensus that amyloid material deposit does not disappear or diminish after satisfactory hematologic response, regardless of renal response. However, the need of a repeat renal biopsy in such situation is still controversial. Case presentation Here we reported a case of histologically confirmed λ Type renal AL amyloidosis who had been classified as Stage I and low risk at initial diagnosis. The patient received a total of six courses of CyBorD chemotherapy. She had achieved complete hematologic remission after two courses of chemotherapy but consistently had large amount of proteinuria over 10 g/day during follow up. A repeat renal biopsy was performed nine months after the first one and indicated mild to moderate increase of amyloid deposits as well as significant glomerulosclerosis and interstitial lesions, suggesting a lack of histological renal improvement despite her satisfactory hematologic response. Conclusions This case indicated renal involvement in AL amyloidosis could progress after successful hematologic treatment, and supported the value of repeat renal biopsy in the evaluation of AL amyloidosis patients lacking renal response despite of complete hematologic remission.

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Section: Discussionmentioning

confidence: 99%