Author:
Fedi Mathilde,Bobot Mickaël,Torrents Julia,Gobert Pierre,Magnant Éric,Knefati Yannick,Verhelst David,Lebrun Gaëtan,Masson Valérie,Giaime Philippe,Santini Julien,Bataille Stanislas,Brunet Philippe,Dussol Bertrand,Burtey Stéphane,Mancini Julien,Daniel Laurent,Jourde-Chiche Noémie
Abstract
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.
Publisher
Springer Science and Business Media LLC
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