TY - JOUR
T1 - Renal disease in the elderly and the very elderly Japanese
T2 - Analysis of the Japan Renal Biopsy Registry (J-RBR)
AU - Yokoyama, Hitoshi
AU - Sugiyama, Hitoshi
AU - Sato, Hiroshi
AU - Taguchi, Takashi
AU - Nagata, Michio
AU - Matsuo, Seiichi
AU - Makino, Hirofumi
AU - Watanabe, Tsuyoshi
AU - Saito, Takao
AU - Kiyohara, Yutaka
AU - Nishi, Shinichi
AU - Iida, Hiroyuki
AU - Morozumi, Kunio
AU - Fukatsu, Atsushi
AU - Sasaki, Tamaki
AU - Tsuruya, Kazuhiko
AU - Kohda, Yukimasa
AU - Higuchi, Makoto
AU - Kiyomoto, Hideyasu
AU - Goto, Shin
AU - Hattori, Motoshi
AU - Hataya, Hiroshi
AU - Kagami, Shoji
AU - Yoshikawa, Norishige
AU - Fukasawa, Yuichiro
AU - Ueda, Yoshihiko
AU - Kitamura, Hiroshi
AU - Shimizu, Akira
AU - Oka, Kazumasa
AU - Nakagawa, Naoki
AU - Ito, Takafumi
AU - Uchida, Shunya
AU - Furuichi, Kengo
AU - Nakaya, Izaya
AU - Umemura, Satoshi
AU - Hiromura, Keiju
AU - Yoshimura, Mitsuhiro
AU - Hirawa, Nobuhito
AU - Shigematsu, Takashi
AU - Fukagawa, Masafumi
AU - Hiramatsu, Makoto
AU - Terada, Yoshio
AU - Uemura, Osamu
AU - Kawata, Tetsuya
AU - Matsunaga, Akira
AU - Kuroki, Aki
AU - Mori, Yasukiyo
AU - Mitsuiki, Koji
AU - Yoshida, Haruyoshi
N1 - Funding Information:
The authors gratefully acknowledge the assistance of their colleagues at the centers and affiliated hospitals who helped with the data collection for the J-RBR/J-KDR. We also sincerely thank Ms. Mayumi Irie in the UMIN-INDICE for establishing and supporting the registration system of J-RBR&J-KDR and Ms. Yoshimi Saito for preparing this manuscript. This study was supported in part by the committee of the Japanese Society of Nephrology and a Grant-in-Aid for Progressive Renal Disease Research from the Ministry of Health, Labour, and Welfare of Japan.
PY - 2012/12
Y1 - 2012/12
N2 - Background and objectives: Data regarding renal disease in the elderly (age ≥65 years old) and very elderly (age ≥80 years old) Japanese are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in elderly patients who underwent renal biopsy. Design, setting, participants, and measurements: From July 2007 to November 2011, all of the elderly native renal biopsy patients who had been registered in the Japan Renal Biopsy Registry (J-RBR; 2802 including 1596 males and 1206 females) were identified. Their data were compared with a control group of 7416 patients who ranged in age from 20 to 64 years old and were registered on the J-RBR over the same period. In addition, the clinical and pathological classifications of 276 very elderly patients were also analyzed. Results: The indications for biopsy were nephrotic syndrome (NS) in 36.2 and 50.7 % of the elderly and the very elderly patients, chronic nephritic syndrome in 31.8 and 17.4 %, and acute kidney injury including rapidly progressive glomerulonephritis in 18.6 and 22.5 %, respectively. Primary glomerular disease was the most frequent diagnosis, followed by MPO-ANCA-positive nephritis, IgA nephropathy (IgAN), and diabetic nephropathy. In primary GN including IgAN, membranous nephropathy (MN) was the most frequent histological type, followed by IgAN and minor glomerular abnormalities. A comparison with the control group showed that MN, MPO-ANCA-positive nephritis, and amyloid nephropathy were more common in the elderly (P < 0.001), and IgAN was less common (P < 0.001). As for nephrotic syndrome in the elderly, MN was the most common histological type, followed by minimal change NS, diabetic nephropathy, amyloid nephropathy, and focal segmental glomerulosclerosis. There was a significant discrepancy between the urinary protein/creatinine ratio and daily proteinuria after the 7th decade of life. Conclusions: Renal biopsy is a valuable diagnostic tool, even in elderly and very elderly Japanese patients. In the future, modified clinical guidelines for elderly renal disease should be developed.
AB - Background and objectives: Data regarding renal disease in the elderly (age ≥65 years old) and very elderly (age ≥80 years old) Japanese are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in elderly patients who underwent renal biopsy. Design, setting, participants, and measurements: From July 2007 to November 2011, all of the elderly native renal biopsy patients who had been registered in the Japan Renal Biopsy Registry (J-RBR; 2802 including 1596 males and 1206 females) were identified. Their data were compared with a control group of 7416 patients who ranged in age from 20 to 64 years old and were registered on the J-RBR over the same period. In addition, the clinical and pathological classifications of 276 very elderly patients were also analyzed. Results: The indications for biopsy were nephrotic syndrome (NS) in 36.2 and 50.7 % of the elderly and the very elderly patients, chronic nephritic syndrome in 31.8 and 17.4 %, and acute kidney injury including rapidly progressive glomerulonephritis in 18.6 and 22.5 %, respectively. Primary glomerular disease was the most frequent diagnosis, followed by MPO-ANCA-positive nephritis, IgA nephropathy (IgAN), and diabetic nephropathy. In primary GN including IgAN, membranous nephropathy (MN) was the most frequent histological type, followed by IgAN and minor glomerular abnormalities. A comparison with the control group showed that MN, MPO-ANCA-positive nephritis, and amyloid nephropathy were more common in the elderly (P < 0.001), and IgAN was less common (P < 0.001). As for nephrotic syndrome in the elderly, MN was the most common histological type, followed by minimal change NS, diabetic nephropathy, amyloid nephropathy, and focal segmental glomerulosclerosis. There was a significant discrepancy between the urinary protein/creatinine ratio and daily proteinuria after the 7th decade of life. Conclusions: Renal biopsy is a valuable diagnostic tool, even in elderly and very elderly Japanese patients. In the future, modified clinical guidelines for elderly renal disease should be developed.
UR - http://www.scopus.com/inward/record.url?scp=84876281536&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876281536&partnerID=8YFLogxK
U2 - 10.1007/s10157-012-0673-8
DO - 10.1007/s10157-012-0673-8
M3 - Article
C2 - 23053590
AN - SCOPUS:84876281536
SN - 1342-1751
VL - 16
SP - 903
EP - 920
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
IS - 6
ER -
