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Pattern of biopsy-proven kidney disease in the elderly in a tertiary care hospital in India: a clinicopathological study

  • Nephrology - Original Paper
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Abstract

Background

An aging population is an important demographic issue in India. The knowledge base about kidney diseases among the elderly Indians is inadequate. We aim to delineate the clinical profile and spectrum of biopsy-proven kidney disease in elderly patients.

Methods

Records of all elderly patients (≥60 years) who had undergone kidney biopsy in the nephrology department from January 2010 to December 2014 were reviewed. Their clinical details and laboratory investigations at the time of biopsy were noted. Details of kidney biopsy were recorded from their biopsy reports.

Results

In total, 1728 patients underwent kidney biopsy during this period and 124 were elderly (7.2 %). Their mean age was 64.9 ± 4.9 years, and they were predominantly males (63.7 %). Mean serum creatinine was 3.0 ± 2.8 mg/dl, proteinuria was 4.0 ± 2.7 g/day, and 39.5 % had microscopic hematuria. The most common indications for biopsy were nephrotic syndrome (NS)—39.5 % and acute kidney injury/rapidly progressive glomerulonephritis (AKI/RPGN)—24.2 %. Another 8.1 % patients had NS with AKI. MN (39.0 %) was the chief cause of NS, and pauci-immune crescentic glomerulonephritis (GN) (28.2 %) was the leading cause of AKI/RPGN. MN, pauci-immune crescentic GN and acute on chronic tubulointerstitial nephritis (A/CTIN) and acute tubular injury (ATI) were more common in the elderly, while MCD, FSGS, IgA nephropathy and lupus nephritis were more frequent in the younger patients. 68.5 % of the elderly patients biopsied were diagnosed with a renal disease which was potentially amenable to specific treatment.

Conclusion

The spectrum of biopsy-proven kidney disease in the elderly Indians seen in our tertiary care hospital varies from the younger population. Kidney biopsy provides useful information with therapeutic and prognostic implications in these patients. The percentage of elderly patients among the total biopsied population is low in India, and these patients present late with renal dysfunction. Prospective studies are needed to assess the outcome of the commonly seen kidney diseases in elderly patients.

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Authors and Affiliations

  1. Department of Nephrology, All India Institute of Medical Sciences, New Delhi, 110029, India

    Soumita Bagchi, Parmod Mittal, Sanjay Kumar Agarwal, Dipankar Bhowmik & Sandeep Mahajan

  2. Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India

    Geetika Singh, Lavleen Singh & Amit Dinda

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  1. Soumita Bagchi
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  2. Parmod Mittal
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  3. Geetika Singh
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  4. Sanjay Kumar Agarwal
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  5. Lavleen Singh
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  6. Dipankar Bhowmik
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  7. Sandeep Mahajan
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Correspondence to Soumita Bagchi.

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Bagchi, S., Mittal, P., Singh, G. et al. Pattern of biopsy-proven kidney disease in the elderly in a tertiary care hospital in India: a clinicopathological study. Int Urol Nephrol 48, 553–560 (2016). https://doi.org/10.1007/s11255-015-1193-8

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  • DOI: https://doi.org/10.1007/s11255-015-1193-8

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