Evaluation of Renal Biopsies in the Elderly: A Single-Center Experience

Öz

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.

Anahtar Kelimeler

• Elderly patients
• Renal biopsy
• Histopathological diagnosis
• Biopsy complications

Yaşlı Bireylerde Renal Biyopsilerin Değerlendirilmesi: Tek Merkezli Bir Deneyim

Öz

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.

Anahtar Kelimeler

• Yaşlı hastalar
• Böbrek biyopsisi
• Histopatolojik tanı
• Biyopsi komplikasyonları

Kaynakça

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