In conclusion, the study covers a long period of time (38 years) and, considering how much epidemiology and treatments have evolved during this period, the outcomes may be different nowadays. Targeted treatment was given to 51.9% of patients, 52.9% of whom had a good clinical response. Eight patients had clinically non-relevant side effects (11.7%). A positive PF 670462 response (defined as a more than 50% reduction of SCr, or by partial or complete remission of proteinuria) was observed in 36 patients (52.9%). 76 Rabbit Polyclonal to SENP8 patients were monitored for 57 9.89 months: 18 patients were on dialysis (follow-up 2.56 3.61 months), 15 died (follow-up 58.5 13.43 months), and 52 remained under nephrologic observation for 36 31 months (SCr was 2.56 0.75 mg/dL and proteinuria was 4.82 6.78 g/day). Conclusion: In our experience, renal biopsy is safe even in very elderly patients; it allowed targeted treatment in 51.9% of patients, 52.9% of whom had a good clinical response, possibly contributing to prolonged patient survival and improved PF 670462 quality of life. strong class=”kwd-title” Keywords: elderly, renal biopsy, glomerulonephritis, renal disease Introduction Demographic analysis shows the ageing of the global population (in Italy people over 75 represented 10% of the population in 2010 2010 and 8.3% in 2002) [1, 2] and the consequent increase in the age of hospitalized subjects [3] and of patients starting dialysis [4]. Despite the increasing age of the dialysis population, little information is available about the causes of renal diseases in older patients. Renal biopsy plays a central role in diagnosing causes of acute renal failure with uncertain etiology and glomerular diseases, which in the elderly are represented most commonly by minimal change disease, membranous glomerulopathy, crescentic glomerulonephritis (GN), and amyloidosis [3, 5, 6]. To ascertain the feasibility, safety, and usefulness of renal biopsy in elderly patients, we retrospectively examined the data of 131 patients over 75 years of age who underwent renal biopsy. They represent 11.1% of the 1,178 renal biopsies performed at our center between 1974 and January 2012. Methods Our Nephrology Unit serves a population of ~ 500,000 inhabitants in Turin located in north-western Italy. The hospitalization rate in the nephrology ward is ~ 500 patients a year. At our center, we performed 1,178 renal biopsies between 1974 and January 2012. We selected 131 individuals (11.1%) over 75 years of age from the entire cohort and examined the complications of the biopsy process, histological analysis, treatment, and the outcome of the individuals. Renal biopsy Renal biopsy is performed with real-time ultrasound (US) guidebook, using automatic 18 evaluate, 15 or 22 cm Tru-Cut needles. Not more than two punctures are made. One individual underwent surgical biopsy. Feasibility criteria PF 670462 for undergoing renal biopsy include: kidney size 8 cm at US exam, bleeding time according to Ivy test 10 min, platelet count number 100,000/mm3, Hb 10 g/dL, and normal coagulation parameters (prothrombin and thromboplastin time). Patients remain in bed for 24 hours following the process. Vital parameters are monitored every hour for the 1st 4 hours and then every 2 hours. US and renal echo-Doppler are performed the day after in order PF 670462 to exclude hematomas and arteriovenous fistulas. Patients remain in hospital for 2 days after the process. Results Biopsy process The biopsy sample allowed analysis to be made in all instances. The mean quantity of glomeruli was 15.9 8.5 per biopsy sample. In 89.2% of samples, there were more than 8 glomeruli. Imply glomerular obsolescence was 28.97 27.9 (0 C 82%) of the total quantity of glomeruli present in the biopsy sample. Individuals Imply age of the 131 individuals (72 males, 59 females) was 78.7 5.73 (75 C 93) years. At the time of biopsy, serum creatinine (SCr) was 4.47 2.56 mg/dL and proteinuria.
