Use of renal biopsy in the elderly

Mohamed, Nasreen

doi:10.1007/s11255-010-9874-9

Cited by 13 publications

(16 citation statements)

References 29 publications

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“…The rate of kidney disease in older patients is higher. [ [ 54 ]. The causes of structural and functional changes of the aging kidney are age and systemic disease (diabetes, hypertension and obesity).…”

Section: Discussionmentioning

confidence: 99%

Patterns of renal disease in South Korea: a 20-year review of a single-center renal biopsy database

et al. 2017

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Background: Several registries and centers have reported the results of renal biopsies from different parts of the world. As there are few data regarding the epidemiology of glomerulonephritis (GN) in South Korea, we conducted this study on renal biopsy findings during the last 20 years from a single center.Methods: Data for 818 patients who underwent renal biopsy at our center between 1992 and 2011 were collected retrospectively. All kidney specimens were examined with light microscopy (LM) and immunofluorescent microscopy (IF).Results: There were 818 cases of native kidney biopsies. In cases of primary GN, the most frequent type of renal pathology in adults (18–59 years) was mesangial proliferative GN (MsPGN, 34.5%) followed by IgA nephropathy (IgAN, 33.3%) and membranous GN (MGN, 8.8%). Indications in adults (18–59 years) were asymptomatic urinary abnormalities (75.3%) followed by nephrotic syndrome (19.8%) and acute kidney injury (AKI, 3.4%).Conclusions: Among 818 renal biopsy specimens, MsPGN and IgAN were the most frequent biopsy-proven renal diseases. MGN was the third most common cause of primary GN and lupus nephritis (LN) was the most common secondary glomerular disease. Our data contribute to the epidemiology of renal disease in South Korea.

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Section: Discussionmentioning

confidence: 99%

Patterns of renal disease in South Korea: a 20-year review of a single-center renal biopsy database

et al. 2017

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“…Kidney disease is highly prevalent among elderly persons [151] . The aging kidney is characterized by structural and functional changes due to age and systemic disease (diabetes, hypertension, obesity) such as glomerulosclerosis, tubulo-interstitial fibrosis, atrophy and, consequently, a reduction in the functional renal reserve, which makes the elderly prone to develop CKD, sooner or later [152][153][154] .…”

Section: Renal Biopsy In the Elderly Settingmentioning

confidence: 99%

“…Although in most cases renal biopsy cannot differentiate between chronic renal damage and age-related changes, some specific conditions may require histological details for a clear-cut diagnosis, etiological frame-working and therapeutic planning [155] . Theoretically, the indications for performing renal biopsy in the elderly should not diverge from those in an adult, non-elderly population [69] ; however, since old patients are more likely to present with decreased renal function, cardiovascular, pulmonary or hematologic comorbidities and poorer general health, a prudent and complete evaluation of risk factors is mandatory for guiding decision to biopsy [151] . Nevertheless, preliminary evidence suggests that the rate and type of complications in the elderly patients do not differ from those observed in the general population [156] .…”

Section: Renal Biopsy In the Elderly Settingmentioning

confidence: 99%

Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

Fiorentino

Bolignano²,

Tesař³

et al. 2016

Am J Nephrol

131

102

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Background: Although the number of patients reaching end-stage kidney disease without a biopsy-proven diagnosis is increasing, the utility of renal biopsy is still an object of debate. We analyzed epidemiological data and the main indications for renal biopsy with a systematic, evidence-based review at current literature. Summary: There is a high discrepancy observed in biopsy rates and in the epidemiology of glomerular diseases worldwide, related to the different time frame of the analyzed reports, lack of data collection, the different reference source population and the heterogeneity of indications. The evidence-based analysis of indications showed that renal biopsy should be crucial in adults with nephrotic syndrome or urinary abnormalities as coexistent hematuria and proteinuria and in corticosteroid resistant-children with severe proteinuria. The knowledge of renal histology can change the clinical management in patients with acute kidney injury significantly, after the exclusion of pre-renal or obstructive causes of kidney damage. Scarce evidence indicates that renal biopsy can be useful in patients with advanced chronic kidney disease and its use should always be considered after weighing the benefits and potential risks. Renal biopsy should be crucial in patients with renal involvement due to systemic disease. In patients with diabetes with atypical features, renal biopsy may be fundamental to diagnose an unexpected parenchymal disease mislabeled as diabetic nephropathy. Finally, in elderly patients, the indications and the risks are not different from those in the general population. Key Message: Renal biopsy still remains a concrete approach for managing a substantial percentage of renal diseases.

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“…However, despite the advantages of being safe, simple, and easy, this invasive procedure is not risk-free [7]. Furthermore, based on our clinical experiences, at times, renal biopsies cannot be performed on certain patients due to contraindications [8,9], patient refusal, and insufficient operative skills of physicians at certain hospitals. Moreover, the pathologic diagnosis obtained from renal biopsies may be variable.…”

Section: Introductionmentioning

confidence: 99%

A novel differential diagnostic model based on multiple biological parameters for immunoglobulin A nephropathy

Gao

Wang

Dong

et al. 2012

BMC Med Inform Decis Mak

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BackgroundImmunoglobulin A nephropathy (IgAN) is the most common form of glomerulonephritis in China. An accurate diagnosis of IgAN is dependent on renal biopsies, and there is lack of non-invasive and practical classification methods for discriminating IgAN from other primary kidney diseases. The objective of this study was to develop a classification model for the auxiliary diagnosis of IgAN using multiparameter analysis with various biological parameters.MethodsTo establish an optimal classification model, 121 cases (58 IgAN vs. 63 non-IgAN) were recruited and statistically analyzed. The model was then validated in another 180 cases.ResultsOf the 57 biological parameters, there were 16 parameters that were significantly different (P < 0.05) between IgAN and non-IgAN. The combination of fibrinogen, serum immunoglobulin A level, and manifestation was found to be significant in predicting IgAN. The validation accuracies of the logistic regression and discriminant analysis models were 77.5 and 77.0%, respectively at a predictive probability cut-off of 0.5, and 81.1 and 79.9%, respectively, at a predictive probability cut-off of 0.40. When the predicted probability of the equation containing the combination of fibrinogen, serum IgA level, and manifestation was more than 0.59, a patient had at least an 85.0% probability of having IgAN. When the predicted probability was lower than 0.26, a patient had at least an 88.5% probability of having non-IgAN. The results of the net reclassification improvement certificated serum Immunoglobulin A and fibrinogen had classification power for discriminating IgAN from non-IgAN.ConclusionsThese models possess potential clinical applications in distinguishing IgAN from other primary kidney diseases.

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Use of renal biopsy in the elderly

Cited by 13 publications

References 29 publications

Patterns of renal disease in South Korea: a 20-year review of a single-center renal biopsy database

Patterns of renal disease in South Korea: a 20-year review of a single-center renal biopsy database

Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

A novel differential diagnostic model based on multiple biological parameters for immunoglobulin A nephropathy

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