Spectrum of Biopsy-Proven Kidney Diseases in Older Saudi Adults, 2001-2017

Abstract

Introduction: Glomerular diseases in the elderly population are a challenging clinical dilemma, and kidney biopsy is of paramount importance to clarify the morphological changes. The aim of this study was to evaluate the prevalence of major glomerulopathies that affect older adults.Methods: This retrospective study included 70 adults aged >65 years and was performed at four tertiary centres in Saudi Arabia between January 2001 and December 2017.Results: There were 74 native kidney biopsies, which accounted for 7.2% of all native renal biopsies that were performed in the 16-year period. Furthermore, 64% of the native biopsied patients were men. The most common clinical presentations were nephrotic syndrome (40%) and acute kidney injury (20%).In older adults with primary glomerular diseases, IgA nephropathy was the most frequent pathological type (36.4%), whereas diabetes mellitus was the most frequent etiology (37.5%) for secondary glomerular diseases. Women were more likely to develop diabetic nephropathy. Conclusion:The prevalence of IgA is progressively increasing and is currently the most frequent type of primary glomerular disease diagnosed in senior adult. Diabetes has become the leading cause of secondary glomerular disease. Renal biopsy is therefore of paramount importance because an accurate diagnosis will help clinicians establish the diagnosis and guide therapy for both younger and older adults.

Morphological Spectrum of Glomerulonephritis in Medical Renal Biopsies: A Single-Center Study

“…A male predominance was noted in our study, with 44 (54.3%) male patients and 37 (45.7%) female patients. This was consistent with other studies conducted globally, including Saudi Arabia, China, and India [ 9 , 13 , 14 ]. In a Chinese survey, male predominance was observed to be 56% [ 14 ].…”

“…According to the World Health Organization classification, glomerulonephritis is divided into two major categories: (1) Primary glomerulonephritis (caused by factors intrinsic to the kidney, which are often idiopathic and without accompanying conditions) includes minimal change disease, IgA nephropathy, membranous, membranoproliferative, and FSGS. (2) Secondary glomerulonephritis (associated with a factor or underlying systemic diseases such as infections, drugs, and metabolic diseases) includes lupus nephritis, diabetes, amyloidosis, post-infectious, and advanced glomerulonephritis [ 9 ].…”

“…IgA nephropathy is the most common primary glomerulonephritis worldwide [9,17,18]. On reviewing the literature of the spectrum of primary glomerular diseases, IgA nephropathy is more common in developed countries such as Saudi Arabia, Kuwait, Poland, Singapore, and the Czech Republic [19][20][21].…”

“…Currently, almost 99.9% of biopsies are diagnostic and result in an accurate diagnosis [8]. Pathologically, different types of renal diseases can vary considerably with factors such as patients' ethnicity, age group, sex, and geographical location/origin [9].…”

“…Pathologically, different types of renal diseases can vary considerably with factors such as patients’ ethnicity, age group, sex, and geographical location/origin [ 9 ].…”