| BackgroundAging has gradually become a common health problem around the world.China is also confronting the problem of population aging.The percentage of elderly in China is predicted to tripe from 8%to 24.48%,by 2040 the total number is about 374million.Aging is a complex and poorly understood process that involves genes,environment and chance.The varied functions of the kidneys influenced by the complex process of aging.The glomerular filtration rate(GFR)and renal plasma flow(RPF)decline with adult aging,the phenomena beginning when people at the age 30.After about age 75the rate of decline of GFR may accelerate,but still does not progress fast enough to cause kidney failure in the human life span.When one reaches 80 years old,the RPF declines more rapidly than GFR,which leads to a modest increase in filtration fraction.With economic development and life expectancy,the proportion of elderly patients(?60 years old)in renal disease increased significantly.And the mean age of patients undergoing renal biopsies has been rising,the histology of different age is variant.Previous studies of renal disease in older people have been limited to those aged 60 or65 years old.In addition,only several studies that included patients 80 years and older are from USA,Europe,Japan.There is no study about patients aged 80 years old in China.Thus our study was to examine the cause of renal disease and their clinical presentations in the group of very elderly patients(over 80 years old)who underwent renal biopsy and to compare the frequency of these diagnosis with a control group of patients aged 65-70 years old.What~`s more the side effects of renal biopsy such as perinephric hematoma,gross hematuria and arteriovenous fistula are also studied.ObjectiveTo examine clinicopathologic presentations in the very elderly patients who underwent renal biopsy and the complications.MethodsFrom May 2012 to March 2016,the patients who underwent renal biopsy from the Nephrology Center of the First Affiliated Hospital of Zhengzhou University were screened.In the observation group,there are very elderly patients(age?80 years old).Their results were compared with that of patients aged 65-70 years old(the control group)over the same period.The clinical and pathological classifications of the two groups were analyzed.The clinical data includes age,gender,blood pressure,blood glucose.Available laboratory data such as serum creatinine concentration(mg/ml),24-hoururineproteinexcretion(g/day),total cholesterol(TC),low-densitylipidcholesterol(LDL-C),high-densitylipid cholesterol(HDL-C),among others were recorded on the first time after entering hospital.The renal pathology were collected which including Renal pathology structure and Immune complex deposition.Then we analyzed the clinical and pathological characteristics as well as the the side effects of renal biopsy.Results1.33 patients include 24 males and 8 females with a median age of 82.67±1.88were enrolled in the observed group.The control group consisted of 100 patients(71males and 29 females;median age 67(range from 66 to 69).2.Primary glomerulopathy was the most frequent pathologic diagnosis of the two groups(60.6%,64%).In the patients of primary glomerulopathy with kidney disease,membranous nephropahty was the most frequent histological type(50%)and the ratio is lower than the control group(62.5%,p>0.05).In the observed group,the ratio of Secondary glomerulopathy was higher than the control group(30.3%vs13%,P<0.05)and the ratio of amyloid nephropathy was also higher(40%vs15.4%,p>0.05),the most frequent histological type,however this different was not significant.3.For the very elderly patients with nephrotic syndrome,glomerular minimal change was the most common histological type(30.4%),followed by membranous nephropathy(26.1%).4.There was no side effects of perinephric hematoma,gross hematuria,arteriovenous fistula or other complications.ConclusionsThe pathology type of the very elderly patients with kidney disease is different with the elderly patients. |
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