P0465NEPHROTIC SYNDROME IN ELDERLY PATIENTS

Abstract

Abstract Background and Aims Nephrotic syndrome (NS) is one of the manifestations of acute or chronic glomerular nephropathy in the elderly. Our study objective was to determine the particularities of NS in the elderly. Method This is a retrospective study, carried out in the Internal Medicine department A of Charles Nicolle hospital at Tunis, between January the 1st, 1975 and December the 31st, 2016. This study included subjects aged 65 years old or over hospitalized for NS. Results We studied 115 patients with an average age of 71 ± 5 years [65-83 years] with a sex ratio (M/F) of 1.7. Twenty-three percent of patients were diabetic. The median proteinuria was 4.7 g/l [3-19.5 g/l], the mean albumin level was 20 ± 6g/l and the mean protidemia was 50.6 ± 6.9 g/l. Nephrotic syndrome was impure in 89.5 % of patients with high blood pressure in 54 % of cases, hematuria ≥2 + in 30% of cases and renal failure in 82.7 % of cases. Renal biopsy was performed in 45 patients. The most common glomerular lesions were Membranous nephropathy (29 %) followed by amyloidosis (24.5 %). NS was secondary in 65.2 % of cases mainly to amyloidosis (35.6 %) and diabetes (19 %). Idiopathic nephropaty was dominated by membranous nephropathy (9.5 %) and primitive primitive (MPGN) (4.3 %). The treatment was symptomatic for 84.4% of patients. Corticosteroids and/or immunosuppressive treatment have been used for 15.6% of patients. At the end of follow-up, 35.3 % of patients achieved complete or partial remission and 56.6 % progressed to ESRD. Conclusion Elderly NS was characterized by a poor prognosis due to delayed cosultation and non-uniform treatment strategies. Multicentric study in order to identify different action axes could improve the prognosis of this disease. Multicentric study in order to identify different action axes could improve the prognosis of this disease.