Kidney biopsy in very elderly patients: indications, therapeutic impact and complications.
BMC Nephrol
; 22(1): 362, 2021 11 02.
Article
en En
| MEDLINE
| ID: mdl-34727880
ABSTRACT
BACKGROUND:
Few data is available on the risk/benefit balance of native kidney biopsy (KB) in very elderly patients.METHODS:
Multicenter retrospective cohort study in the Aix-Marseille area the results of KB and medical charts of all patients over 85 years biopsied between January 2010 and December 2018 were reviewed.RESULTS:
104 patients were included. Median age was 87 years. Indications for KB were acute kidney injury (AKI) in 69.2% of patients, nephrotic syndrome (NS) with AKI in 13.5%, NS without AKI in 12.5%, and proteinuria in 4.8%. Median serum creatinine was 262 µmol/L, 21% of patients required dialysis at the time of KB. Significant bleeding occurred in 7 (6.7%) patients, requiring blood cell transfusion in 4 (3.8%), and radiological embolization in 1 (1%). The most frequent pathological diagnoses were non-diabetic glomerular diseases (29.8%, including pauci-immune crescentic glomerulonephritis in 9.6%), hypertensive nephropathy (27.9%), acute interstitial nephritis (16.3%), renal involvement of hematological malignancy (8.7%), and acute tubular necrosis (6.7%). After KB, 51 (49%) patients received a specific treatment corticosteroids (41.3%), cyclophosphamide (6.7%), rituximab (6.7%), bortezomib (3.8%), other chemotherapies (3.8%). Median overall survival was 31 months.CONCLUSIONS:
KB can reveal a diagnosis with therapeutic impact even in very elderly patients. Severe bleeding was not frequent in this cohort, but KB may have not been performed in more vulnerable patients.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Proteinuria
/
Lesión Renal Aguda
/
Riñón
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Síndrome Nefrótico
Tipo de estudio:
Etiology_studies
/
Incidence_studies
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Observational_studies
/
Risk_factors_studies
Límite:
Aged80
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Female
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Humans
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Male
Idioma:
En
Año:
2021
Tipo del documento:
Article