Analysis for clinical and pathological features of elderly patients with kidney diseases

Abstract

Objective To analyze the clinical and renal pathological features of over-60-year-old patients with kidney diseases. Methods A total of 742 elderly patients diagnosed with the renal biopsy from January 2010 to December 2016 were retrospectively analyzed for the gender, age, primary disease, and renal pathology types. Chi-square test was used to compare the incidence of renal biopsy complications between elderly and young patients, and the data were treated with SPSS 19.0 statistical software. Results ① There were altogether 742 elderly patients, who aged 60-88 years, with an average age of (72.7 ± 11.3) years, among whom 637 patients (85.8%) aged 60-74 years, and 105 cases (14.2%) aged 75-88 years, with 426 males (57.4%). ② Between the less-than-60-year-old patients diagnosed with the renal biopsy during the same period of time, and the over-60-year-old patients, there were no statistically significant differences in the risk of severe bleeding complications including perirenal big hematoma, blood transfusion requirement, and renal artery embolization (χ2=0.457, 0.108, 0.199, respectively, all P>0.05). ③ There were 331 cases with hypertension (44.6%), 272 cases with anemia (36.7%), 199 cases with hyperuricemia (26.8%), and 257 cases with hypoproteinemia (34.6%). The proportions of patients with CKD stages 1-5 were 27.4%, 33.8%, 29.8%, 7.1%, and 1.9%, respectively. ④ Among the 742 elderly patients, there were 390 cases with primary glomerular diseases (52.6%), 268 cases with secondary glomerular diseases (36.1%), 72 cases with tubulointerstitial diseases (9.7%), and 12 cases with other diseases (1.6%). Membranous nephropathy (30.4%) and mesangial proliferative glomerulonephritis (17.3%) were the most common among the primary kidney diseases, while among the secondary kidney diseases, diabetic nephropathy accounted for 21.3%, hypertensive kidney damage 12.3%, and tumor-related kidney damage 11.9%. Conclusions Hypertension, anemia, and hyperuricemia are the most common in elderly patients with kidney diseases. Membranous nephropathy predominated the primary kidney diseases, while diabetic nephropathy and tumor-related kidney damage predominated the secondary kidney diseases. In the elderly patients, secondary causes should be screened. For elderly patients with kidney diseases, if without contraindications, the renal biopsy should be actively conducted for determining the pathological type, guiding the treatment, and evaluating the prognosis. Key words: Elderly; Kidney disease; Pathological classification; Clinical manifestation