Indicaciones, histopatología y seguridad de la biopsia renal percutánea: comparativa entre anciano (65-79 años) y muy anciano (80 años o más)

Abstract

BackgroundRenal biopsy is the gold standard for the diagnosis of kidney diseases. Our aim was to analyze the indications, safety and histopathological results of renal biopsy in persons aged 65 years or older, divided into 2 groups: a group of elderly patients (aged 65 to 79 years) and a group of very elderly patients (80 years or more). Material and methodsWe carried out a descriptive retrospective study of 79 native renal biopsies performed in persons aged 65 years or older in the General Hospital of Segovia between 2004 and 2012. Overall, the mean age of the patients was 76.50±5.6 years (range 66-89 years); 58.2% were men and 41.8% were women. Renal biopsy was performed percutaneously under ultrasound guidance in real time, using a 16 G automatic needle. The statistical analysis was performed with SPSS 15.0. ResultsA total of 45.4% of the renal biopsies performed in our hospital corresponded to persons aged 65 years or more: 76% in elderly patients and 24% in very elderly patients. Overall, diagnosis was based on renal biopsy alone in 93.7% of the patients. The mean number of glomeruli per renal biopsy was 10.91±6 (range, 2-29). There were only 2 major complications. The main indications for renal biopsy were acute renal failure/rapidly progressive renal failure and nephrotic syndrome. IgA nephritis was found only in the group aged 65-79 years. There were no cases of lupus nephritis. ConclusionsAccording to our data, renal biopsy is a safe and effective procedure that is less frequently performed in persons aged 80 years old or older.