TY - JOUR T1 - Evaluation of Renal Biopsies in the Elderly: A Single-Center Experience TT - Yaşlı Bireylerde Renal Biyopsilerin Değerlendirilmesi: Tek Merkezli Bir Deneyim AU - Cetin, Taha Enes AU - Tomar, Veysel Baran AU - Demirezen, Asil AU - Gönül, İpek Işık AU - Öğüt, Betül AU - Akçay, Ömer Faruk AU - Derıcı, Ulver AU - Helvacı, Özant PY - 2025 DA - September Y2 - 2025 DO - 10.20515/otd.1717838 JF - Osmangazi Tıp Dergisi PB - Eskişehir Osmangazi Üniversitesi WT - DergiPark SN - 1305-4953 SP - 878 EP - 885 VL - 47 IS - 6 LA - en AB - Chronic kidney disease (CKD) is increasingly prevalent in the elderly population, necessitating precise diagnostic approaches such as renal biopsy. However, concerns about procedural risk often deter clinicians from performing biopsies in older adults. To evaluate the clinical indications, histopathological findings, and complication rates of native kidney biopsies in patients aged 65 years and older. This retrospective single-center study included 165 elderly patients who underwent native kidney biopsy between 2008 and 2024. Demographic, clinical, laboratory, and histopathological data were analyzed. Biopsies of transplanted kidneys and those with inadequate clinical or pathological information were excluded. The mean age of the cohort was 70.7±4.9 years, and 60.6% were male. The most common indication for biopsy was nephrotic syndrome (63%), followed by acute kidney injury (24.2%). Membranous glomerulopathy (18.8%) was the most frequent histopathological diagnosis, followed by pauci-immune glomerulonephritis (13.9%) and AA amyloidosis (10.9%). Renal replacement therapy was required in 20.6% of cases. Biopsy-related complications were infrequent, including hematoma (1.8%), transfusion requirement (1.8%), and angiographic intervention (0.6%), with no procedure-related mortality. Renal biopsy in the elderly demonstrates high diagnostic yield and a low complication rate. Membranous glomerulopathy, pauci-immune glomerulonephritis, and AA amyloidosis were the leading treatable diagnoses. These findings support perform renal biopsy in older patients when clinically indicated, emphasizing that advanced age alone should not preclude histopathologic evaluation. KW - Elderly patients KW - Renal biopsy KW - Histopathological diagnosis KW - Biopsy complications N2 - Kronik böbrek hastalığı (KBH), yaşlı popülasyonda giderek daha yaygın hale gelmekte ve renal biyopsi gibi kesin tanısal yaklaşımları gerekli kılmaktadır. Bununla birlikte, işlem riskine ilişkin endişeler, klinisyenleri ileri yaşlı bireylerde biyopsi yapmaktan sıklıkla alıkoymaktadır. Bu çalışmada, 65 yaş ve üzeri hastalarda yapılan natif böbrek biyopsilerinin klinik endikasyonları, histopatolojik bulguları ve komplikasyon oranlarının değerlendirilmesi amaçlandı. Bu retrospektif tek merkezli çalışmaya, 2008–2024 yılları arasında natif böbrek biyopsisi uygulanan 165 yaşlı hasta dahil edildi. Demografik, klinik, laboratuvar ve histopatolojik veriler analiz edildi. Transplant böbrek biyopsileri ve klinik veya patolojik verileri yetersiz olgular çalışma dışında bırakıldı. Kohortun ortalama yaşı 70,7±4,9 yıl olup, %60,6’sı erkekti. En sık biyopsi endikasyonu nefrotik sendromdu (%63), bunu akut böbrek hasarı (%24,2) izledi. En sık histopatolojik tanı membranöz glomerülopati (%18,8) idi; ardından pauci-immün glomerülonefrit (%13,9) ve AA amiloidozu (%10,9) geldi. Vakaların %20,6’sında renal replasman tedavisi gerekti. Biyopsi ilişkili komplikasyonlar seyrek görüldü: hematom (%1,8), transfüzyon gereksinimi (%1,8) ve anjiyografik girişim (%0,6); işlem ilişkili mortalite saptanmadı. Yaşlılarda yapılan renal biyopsi yüksek tanısal değer ve düşük komplikasyon oranı göstermektedir. Membranöz glomerülopati, pauci-immün glomerülonefrit ve AA amiloidozu en sık saptanan ve tedavi edilebilir tanılar olmuştur. Bulgular, klinik olarak endike olduğunda ileri yaşın tek başına histopatolojik değerlendirmeye engel olmaması gerektiğini desteklemektedir. CR - 1. Kovesdy, C.P., Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011), 2022. 12(1): p. 7-11. CR - 2. López-Otín, C., et al., Hallmarks of aging: An expanding universe. Cell, 2023. 186(2): p. 243-278. CR - 3. Bello, A.K., E. Nwankwo, and A.M. El Nahas, Prevention of chronic kidney disease: A global challenge. Kidney International, 2005. 68: p. S11-S17. CR - 4. Glassock, R.J. and A.D. Rule, Aging and the Kidneys: Anatomy, Physiology and Consequences for Defining Chronic Kidney Disease. Nephron, 2016. 134(1): p. 25-9. CR - 5. Glassock, R., A. Denic, and A.D. Rule, When kidneys get old: an essay on nephro-geriatrics. J Bras Nefrol, 2017. 39(1): p. 59-64. CR - 6. Xiong, M., et al., Kidney Biopsies in Elderly Chinese Patients: A Nationwide Survey. American Journal of Kidney Diseases, 2020. 76(2): p. 295-297. CR - 7. Verde, E., et al., Renal biopsy in very elderly patients: data from the Spanish Registry of Glomerulonephritis. American journal of nephrology, 2012. 35(3): p. 230-237. CR - 8. Moutzouris, D.A., et al., Renal biopsy in the very elderly. Clin J Am Soc Nephrol, 2009. 4(6): p. 1073-82. CR - 9. Shin, J.H., et al., Renal biopsy in elderly patients: clinicopathological correlation in 117 Korean patients. Clin Nephrol, 2001. 56(1): p. 19-26. CR - 10. Nair, R., J.M. Bell, and P.D. Walker, Renal biopsy in patients aged 80 years and older. Am J Kidney Dis, 2004. 44(4): p. 618-26. CR - 11. Oktan, M., et al., Kidney Biopsy in Older Individuals: Impact on Patient Management, Risks, and Consequences - Single Center Experience. Turkish Journal of Nephrology, 2020. 29: p. 134-140. CR - 12. The aging kidney: A 10-year renal biopsy study of geriatric population. Annals of Medical Research, 2021. 26(8): p. 1629-1634. CR - 13. Oguz, Y., et al., Renal Biopsy in Patients Aged 65 Years and Older: A Clinicopathological Analysis. Turkish Nephrology Dialysis Transplantation, 2010. 19: p. 174-179. CR - 14. Ozeki, T., et al., Clinical manifestations of focal segmental glomerulosclerosis in Japan from the Japan Renal Biopsy Registry: age stratification and comparison with minimal change disease. Scientific Reports, 2021. 11(1): p. 2602. CR - 15. Uezono, S., et al., Renal Biopsy in Elderly Patients: A Clinicopathological Analysis. Renal Failure, 2006. 28(7): p. 549-555. CR - 16. Whittier, W.L., et al., Comparison of native and transplant kidney biopsies: diagnostic yield and complications. Clin Kidney J, 2018. 11(5): p. 616-622. UR - https://doi.org/10.20515/otd.1717838 L1 - https://dergipark.org.tr/tr/download/article-file/4951077 ER -