Clinical and pathological analysis of renal biopsies of elderly patients in Northeast China: a single-center study

Ren Fail. 2021 Dec;43(1):851-859. doi: 10.1080/0886022X.2021.1923527.

Abstract

Purpose: To identify the clinical characteristics, histopathological features, and prognosis of kidney disease in a large cohort of elderly patients from Northeast China.

Methods: We retrospectively analyzed the renal disease spectrum in 7,122 patients who underwent renal biopsies at the Second Hospital of Jilin University from 2006 to 2020. Patients were grouped according to age: below 60 years (non-elderly group, n = 5923) and at least 60 years (elderly group, n = 1199). The clinical and pathological characteristics of renal biopsy patients in the groups were analyzed using the t-test and chi-square test.

Results: Compared with the non-elderly group, the elderly group had significantly fewer patients with primary glomerulonephritis, but more patients with tubulointerstitial disorders (p < .05). The incidence of IgA nephropathy, mesangial proliferative glomerulonephritis, and lupus nephritis was significantly lower in elderly patients than in non-elderly patients. The incidence of membranous nephropathy, membranoproliferative glomerulonephritis, diabetic nephropathy, hypertensive nephropathy, systemic vasculitis-associated renal damage, and amyloid nephropathy was significantly higher in elderly patients than in non-elderly patients (p < .05). The incidence of perinephric hematoma (≥4 cm2) in elderly patients with renal biopsy was lower than that in non-elderly patients. We noted that 79.9% of primary glomerulonephritis patients who received immunosuppressive therapy showed a remission rate of 83.5%.

Conclusion: The spectrum of kidney disease in the elderly is different from that in the younger population.

Keywords: elderly; pathology; primary glomerulonephritis; prognosis; renal biopsy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biopsy*
  • China / epidemiology
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / pathology
  • Female
  • Glomerulonephritis / epidemiology*
  • Glomerulonephritis / pathology
  • Glomerulonephritis, IGA / epidemiology
  • Glomerulonephritis, IGA / pathology
  • Glomerulonephritis, Membranoproliferative / epidemiology
  • Glomerulonephritis, Membranoproliferative / pathology
  • Glomerulonephritis, Membranous / epidemiology
  • Glomerulonephritis, Membranous / pathology
  • Humans
  • Hypertension, Renal / epidemiology*
  • Hypertension, Renal / pathology
  • Incidence
  • Kidney / pathology
  • Lupus Nephritis / epidemiology
  • Lupus Nephritis / pathology
  • Male
  • Middle Aged
  • Nephritis / epidemiology*
  • Nephritis / pathology
  • Retrospective Studies

Supplementary concepts

  • Hypertensive Nephropathy

Grants and funding

The authors gratefully acknowledge the financial supports by the National Natural Science Foundation of China [81970628], Department of Science and Technology of Jilin Province [20190304042YY, 20200201488JC], the Health and Family Planning Commission of Jilin Province [2018J048] and the Education Department of Jilin Province [JJKH20190056KJ].