Clinicopathological Evaluation of Renal Biopsies Among Older Adults in Turkiye

Abstract

Aim: Kidney disease is common in older adults due to age-related structural and functional changes in the kidneys, higher rates of chronic disease, and increased drug use. As societies age, there is a rise in the prevalence of renal disease and the number of kidney biopsies being performed in older patients. This study aimed to investigate renal biopsy indications, complications, pathology results, and subsequent treatment among older adults in Turkey. Materials and Methods: We retrospectively analyzed data from patients aged 65 and over who underwent renal biopsy in a university nephrology department between 2004 and 2023. The patients’ demographic information, chronic comorbidities, biopsy indications, pre-biopsy laboratory values, post-biopsy complications, pathology results, and post-biopsy treatments were obtained by reviewing their medical records and biopsy reports. Results: A total of 66 patients were included in the study. The median age was 73.0 years (IQR: 68.8-79.0 years) and 66.7% of the patients were men. The most common comorbidities were hypertension (83.3%), diabetes mellitus (24.3%), coronary artery disease (22.7%), and chronic kidney disease (21.2%). The most common indication for renal biopsy was nephrotic-range proteinuria (56.1%), followed by acute kidney injury (24.2%). When the pathology results were examined, primary glomerulonephritis (62.1%) was the most common result, followed by secondary glomerulonephritis (21.2%) and tubulointerstitial nephritis (12.1%). The most common histopathological diagnoses in primary glomerulonephritis were membranous glomerulonephritis (39.4%) and focal segmental glomerulosclerosis (12.1%), while those in secondary glomerulonephritis were secondary amyloidosis (9.1%) and lupus nephritis (4.5%). After biopsy, 54.5% of the patients received immunosuppressive therapy and 34.8% received renal replacement therapy. No post-biopsy complications were observed. Conclusion: Although the most common indication for kidney biopsy in older adults is nephrotic-range proteinuria. Kidney biopsy is the gold standard method for the diagnosis of renal parenchymal diseases and is a safe procedure in older patients, with low complication rates. Kidney biopsy should not be avoided in geriatric patients if deemed clinically necessary.

Keywords

• elderly
• kidney biopsy
• pathology
• glomerulonephritis
• complication