Renal pathology of elderly patients with renal biopsy: a retrospective analysis in a single unit

Abstract

Objective To explore the pathological characteristics of elderly patients with renal biopsy in recent ten years. Methods Clinical and pathological data were analyzed in 408 elderly patients undergoing renal biopsy in the hospital between November 2005 and November 2015. According to the time of receiving renal biopsy, the patients were divided into two groups: group A(patients receiving biopsy between November 2005 and October 2010) and group B (patients receiving biopsy between November 2010 and November 2015). Results The main clinical presentation was nephrotic syndrome (61.8%) and chronic nephritis syndrome (29.4%). Compared with the patients from 2005 to 2010, the proportion of renal biopsy due to acute renal failure was decreased in recent 5 years (P<0.001) . Patients with primary glomerular disease were 67.4%(275/408), while secondary glomerular diseases were 26.0%(106/408). Patients with tubulo-interstitial disease accounted for 2.2%(9/408)and patients incorporated with two renal diseases were 3.2%(13/408). The diagnosis rate of tubulo-interstitial disease was significantly decrease in group B (P<0.05). In patients with primary glomerular diseases, membranous nephropathy was the most common pathologic category which accounting for 60.0% followed by IgA nephropathy which accounting for 13.5%. Meanwhile, in patients with secondary glomerular diseases, the major pathological types were hepatitis B virus-associated glomerulonephritis (14.2%), systemic vasculltis-associated glomerulonephritis(14.2%), respectively. The diagnosis rate of hepatitis B virus-associated glomerulonephritis in the patients from Guangdong was significantly higher in group B (P<0.05). Conclusions Primary glomerular disease is the most common renal disease in elderly patients with renal biopsy. The major pathologic category of primary glomerular diseases is membranous nephropathy, while the major pathologic type of secondary glomerular disease is hepatitis B virus-associated glomerulonephritis. The diagnosing rate of tubule-interstitial disease is significantly decrease in recent 5 years which accounting for the decreasing of patients who undergoing renal biopsy due to acute renal failure. Clinicians should pay more attention to receive renal biopsy in patients with acute renal failure. The diagnosing rate of hepatitis B virus-associated glomerulonephritis is significantly higher followed by the routine detection of hepatitis-B antigen in renal biopsy. It suggests that routine detection of hepatitis-B antigen in renal biopsy will be benefit to diagnose. Key words: Kidney Diseases; Biopsy; Aged