Clinicopathologic Spectrum of Nephrotic Syndrome in the Elderly
Abstract
The elderly population is affected by a wide range of kidney diseases like young adult patients. However, their clinical course and morphological manifestations are affected by aging. Recognition, diagnosis, and management of glomerular disease in elderly persons have several unique challenges. We aimed to study the clinicopathologic spectrum of elderly patients with nephrotic syndrome (NS). In this retrospective study, we looked at 234 patients of adult NS who were biopsied during the last 5 years. Among them, 31 patients were above the age of 60 years (Elderly). Mean age in elderly patients was 67.48 ± 6.11 years, with age range from 60 to 86 years. Elderly NS patients constituted 13.2% of total adult NS patients. Nineteen patients (61.2%) were males and 12 (38.7%) were females. Hematuria was observed in 19% and hypertension in 48% patients. Mean serum albumin was 2.79 ± 0.39 g/dl and mean 24 h urinary protein was 3.77 ± 0.8 grams. Membranous nephropathy (MN) followed by minimal change disease (MCD) was the most common diagnosis. No major complication with biopsy was reported in our study as has been the case with most studies.
Keywords
How to Cite
References
Rosner M, Abdel-Rahman E, Williams ME, for the ASN Advisory Group on Geriatric Nephrology. Geriatric nephrology: Responding to a growing challenge. Clin J Am Soc Nephrol. 2010;5(5):936–42. 10.2215/CJN.08731209
Kanasi E, Ayilavarapu S, Jones J. The aging population: Demographics and the biology of aging. Periodontol 2000. 2016;72:13–18. 10.1111/prd.12126
Prakash J, Saxena RK, Sharma OP, Usha. Spectrum of renal diseases in the elderly: Single center experience from a developing country. Int Urol Nephrol. 2001;33:227–33. 10.1023/A:1015279619491
Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 2016;23:19–28. 10.1053/j.ackd.2015.08.004
Zech P, Colon S, Pointet P, Deteix P, Labeeuw M, Leitienne P. The nephrotic syndrome in adults aged over 60: Etiology, evolution and treatment of 76 cases. Clin Nephrol. 1982;17(5):232–6.
Yokoyama H, Sugiyama H, Narita I, et al. Outcomes of primary nephrotic syndrome in elderly Japanese: Retrospective analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol. 2015;19:496–505. 10.1007/s10157-014-1022-x
Chen Y, Li P, Cui C, Yuan A, Zhang K, Yu C. Biopsy-proven kidney diseases in the elderly: Clinical characteristics, renal histopathological spectrum and prognostic factors. J Int Med Res. 2016;44:1092–102. 10.1177/0300060516660247
Koshy PJ, Parthsarathy R, Mathew M, Prabakaran R, Kuruvilla S, Abraham G. Interpretation of kidney biopsy in Indian patients older than 60 years: A tertiary care experience. Indian J Nephrol. 2018;28:198–202. 10.4103/ijn.IJN_158_17
Tse KC, Lam MF, Yip PS, et al. Idiopathic minimal change nephrotic syndrome in older adults: Steroid responsiveness and pattern of relapses. Nephrol Dial Transplant. 2003;18:1316–20. 10.1093/ndt/gfg134
Glassock RJ. An update on glomerular disease in the elderly. Clin Geriatr Med. 2013;29:579–91. 10.1016/j.cger.2013.05.007
Johnston PA, Brown JS, Davison AM. The nephrotic syndrome in the elderly: Clinico-pathological correlations in 317 patients. Geriatric Nephrol Urol. 1992;2:85–90. 10.1007/BF00451670
Moutzouris DA, Herlitz L, Appel GB, Markowitz GS, Freudenthal B, Radhakrishnan J, et al. Renal biopsy in the very elderly. Clin J Am Soc Nephrol. 2009 Jun;4(6):1073–82. 10.2215/CJN.00990209
Sato H, Saito T, Furuyama T, Yoshinaga K. Histologic studies on the nephrotic syndrome in the elderly. Tohoku J Exp Med. 1987 Nov;153(3):259–64. 10.1620/tjem.153.259
Gorsane I, Ayed TB, Hajji M, Barbouch S, Abdallah TB. Nephrotic syndrome in elderly: Etiologies, management, and prognosis. Saudi J Kidney Dis Transpl. 2021;32(5):1388–96. 10.4103/1319-2442.344759
Copyright and licence
Copyright (c) 2023 Sheikh Zubair, Junaid Ahmed, Syed Mubashir Nissar, Muzamil Rashid Pala, Aabid Hussain , Murtaza Rashid Pala, Muzamil Latief

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

