Department of Nephrology, Beaumont Hospital, Dublin, Ireland.
J Nephrol. 2012 Mar-Apr;25(2):240-4. doi: 10.5301/JN.2011.8447.
Renal disease is being increasingly diagnosed in the elderly. However, reports on biopsy-confirmed renal disease in this population are limited. The aim of this study was to give an overview of the most important indications, diagnoses and outcomes of renal biopsies in the elderly in our center.
This was a retrospective review of all elderly renal biopsies over 5 years. Patients were eligible for inclusion if they were aged ≥65 years and had had a native kidney biopsy performed. The data recorded included age, sex, indications for biopsy, histological diagnoses and outcomes.
During this time, 1,372 native renal biopsies were performed. Of these, 236 (17%) were in patients aged ≥65 years; 150 male (64%) and 86 female (36%). The most common indications for biopsy were acute renal failure and nephrotic syndrome. Common diagnoses included pauci-immune crescentic glomerulonephritis, tubulointerstitial nephritis, membranous nephropathy, IgA nephropathy and chronic thrombotic microangiopathy. Long-term follow-up of 3 years was available for 102 patients; median serum creatinine at the time of biopsy was 427 µmol/L (interquartile range 204-702) and at 3 years post biopsy had fallen to 192 µmol/L (interquartile range 152-408).
In our center, 17% of native kidney biopsies are performed in elderly patients aged ≥65 years. In our experience, this procedure was safe and had a 97% diagnostic rate. The available follow-up data of patients suggest that renal histology is not only of benefit in diagnosis but also of potential value in terms of prognosis and treatment.
肾脏疾病在老年人中越来越常见。然而，目前关于该人群活检确诊肾脏疾病的报道有限。本研究旨在概述我们中心老年患者进行肾活检的最重要适应证、诊断和结局。
这是一项回顾性研究，纳入了过去 5 年中所有年龄≥65 岁且进行了肾活检的老年患者。患者符合纳入标准：年龄≥65 岁，且进行了肾活检。记录的数据包括年龄、性别、活检适应证、组织学诊断和结局。
在此期间，共进行了 1372 例肾活检，其中 236 例（17%）患者年龄≥65 岁，150 例（64%）为男性，86 例（36%）为女性。最常见的活检适应证为急性肾衰竭和肾病综合征。常见的诊断包括寡免疫性新月体肾小球肾炎、间质性肾炎、膜性肾病、IgA 肾病和慢性血栓性微血管病。102 例患者可获得 3 年的长期随访，活检时血清肌酐中位数为 427µmol/L（四分位距 204-702），活检 3 年后降至 192µmol/L（四分位距 152-408）。
在我们中心，17%的肾活检用于年龄≥65 岁的老年患者。根据我们的经验，该操作安全，诊断率为 97%。目前可获得的患者随访数据表明，肾脏组织学不仅有助于诊断，而且对预后和治疗也具有潜在价值。
