Glomerular disease in the elderly: incidence and clinicopathologic findings. A 20 year retrospective study

Abstract

Glomerular disease in the elderly is frequently attributed to a preexisting or extrarenal disease, and the true incidence of this kind of pathology is yet to be determined. We have analyzed 2375 renal biopsies performed in our hospital in the last 20 years (January 1970 to December 1990). Sixty-two (2.6%) belonged to patients older than 60 years of age (mean age 67.2±6.4 years), 45 males (72.6%) and 17 females (27.4%). The histopathologic findings include: extracapillary proliferation (16 patients), membranoproliferative (11 pts), membranous nephroapthy (7 pts), focal-segmental glomerulosclerosis (6 pts), mesangial glomerulonephritis (4 pts), minimal change disease (3 pts), amyloidosis (7 pts), diabetic glomerulosclerosis (7 pts) and Wegener's disease (1 pt). 43.5% of the biopsies corresponded to primary GN and the remaining 56.5% were secondary to systemic disease. The most frequent clinical findings at the time of the biopsy were: nephrotic syndrome in 25 patients and acute renal failure in 22. There were 13 cases of initial diagnostic errors. We conclude that glomerulonephritis is not rare in elderly patients, showing a similar clinical presentation to that in young adults. Finally, the small number of renal biopsies performed in aged patients in our center could be related to the low index of suspicion of these diseases.