Interpretation of kidney biopsy in Indian patients older than 60 years: A tertiary care experience

Koshy, Priyanka; Parthsarathy, R; Mathew, Milly; Prabakaran, Rudreshwar; Kuruvilla, Sarah; Abraham, Georgi

doi:10.4103/ijn.ijn_158_17

Cited by 9 publications

(8 citation statements)

References 14 publications

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“…Males dominated our biopsy cohort making up to 70%, a finding noted by other Indian studies as well. [ 15 16 17 ] Nephrotic syndrome was the most common indication for elderly patients to undergo renal biopsy, a finding consistent with other Indian [ Table 2 ] and western studies. [ 18 20 ] MGN was the commonest cause of nephrotic syndrome followed by amyloidosis.…”

Section: Discussionsupporting

confidence: 86%

“…Almost 14% of the patients undergoing renal biopsy at our center were elderly. This is lower than the study from south India, which reported 30% elderly in their biopsy cohort[ 15 ] but is higher than that reported from north India[ 16 17 ] [ Table 2 ]. This proportion of the elderly population is lower than those of developed countries like Europe and the USA, where it contributes to about 23% and 25% of kidney biopsies, respectively.…”

Section: Discussioncontrasting

confidence: 70%

“…In our study, pANCA positive pauci-immune crescentic GN was the most common cause of crescentic GN. However, studies from south India and east India[ 15 28 29 ] had found a low incidence of crescentic GN. This could be due to regional variations in the presentation of disease in the elderly.…”

Section: Discussionmentioning

confidence: 99%

“…[ 30 ] AKI was the third common indication for biopsy in our study, accounting for 13% of all biopsies performed, which is comparable to other Indian studies. [ 15 16 ] Sepsis, acute interstitial nephritis, and ATN due to NSAIDs were the common cause of AKI.…”

Section: Discussionmentioning

confidence: 99%

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Gerontolizing nephrology: Spectrum of histopathological findings of kidney biopsy in the elderly

et al. 2020

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Introduction: The spectrum of renal disorder in the elderly differs from the younger population. There is a paucity of literature regarding kidney biopsy in elderly. This study aims to highlight the clinical profile and histopathological spectrum of the elderly patient undergoing a renal biopsy. Materials and Methods: This retrospective study included all patients (age ≥60 years) undergoing native renal biopsies from January 2012 to December 2017. The clinical profile, laboratory parameters, and renal biopsy findings of these patients were recorded from the case files. Results: Out of 1656 renal biopsies performed during the study period, 230 (13.9%%) performed on the elderly were included. Mean age was 64.02 ± 7.87 years (Range: 60-87 years), and males were predominant (70.4%). The commonest indication for biopsy was nephrotic syndrome (NS) (49.6%) followed by Rapidly progressive renal failure (RPRF) (20.9%) and Acute Kidney Injury (AKI) (15.7%). The most frequent histological diagnosis was membranous nephropathy (15.2%) followed by amyloidosis (13.9%) and Focal Segmental Glomerulosclerosis (FSGS) (13.0%). The commonest cause of NS was MGN (29.8%) followed by FSGS (24.6%) and amyloidosis (22.8%). The commonest cause of nephritic syndrome was Diffuse Proliferative Glomerulonephritis (29.4%) and Membranoproliferative Glomerulonephritis (29.4%). Hypertensive nephrosclerosis (40.0%) and diabetic nephropathy (26.7%)) were the commonest histological diagnosis in the patients who underwent renal biopsy for clinical Chronic kidney disease. Crescentic GN (35.4%) and Myeloma cast nephropathy 14.6%) were the commonest cause of RPRF while Acute Tubular Necrosis (41.7%) was the commonest cause of AKI. None of the patients had major complications. Conclusion: Renal biopsy is safe in the elderly and provides a wealth of information with regards to the diagnosis and prognosis of renal disorder.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Gerontolizing nephrology: Spectrum of histopathological findings of kidney biopsy in the elderly

et al. 2020

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“…In this review, we will focus on the clinicopathological characteristics of certain recurrent glomerular diseases: immunoglobulin A (IgA) nephropathy,[ 4 5 ] membranous nephropathy (MN),[ 5 6 ] focal segmental glomerulosclerosis (FSGS),[ 5 ] lupus nephritis, complement-mediated glomerulonephritis,[ 5 ] and some monoclonal gammopathy-related renal diseases.…”

Section: Introductionmentioning

confidence: 99%

Recurrent glomerulonephritis in the kidney allograft

Bobart¹,

Alexander²,

Bentall³

2020

Indian J Nephrol

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Renal transplantation is the preferred form of renal replacement therapy in patients who develop end-stage kidney disease (ESKD). Among the diverse etiologies of ESKD, glomerulonephritis is the third most common cause, behind hypertensive and diabetic kidney disease. Although efforts to prolong graft survival have improved over time with the advent of novel immunosuppression, recurrent glomerulonephritis remains a major threat to renal allograft survival despite concomitant immunosuppression. As a result, clinical expertise, early diagnosis and intervention will help identify recurrent disease and facilitate prompt treatment, thus minimizing graft loss, resulting in improved outcomes. In this review, we highlight the clinicopathologcal characteristics of certain glomerular diseases that recur in the renal allograft.

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