Kidney biopsy in very elderly patients: indications, therapeutic impact and complications
Abstract Background Few data is available on the risk/benefit balance of native kidney biopsy (KB) in very elderly patients. Methods Multicenter retrospective cohort study in the Aix-Marseille area: the results of KB and medical charts of all patients over 85 years biopsied between January 2010 and...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
BMC
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/7defd54093a145f3a9c5a3be4a1445c6 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:7defd54093a145f3a9c5a3be4a1445c6 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:7defd54093a145f3a9c5a3be4a1445c62021-11-08T11:17:57ZKidney biopsy in very elderly patients: indications, therapeutic impact and complications10.1186/s12882-021-02559-91471-2369https://doaj.org/article/7defd54093a145f3a9c5a3be4a1445c62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12882-021-02559-9https://doaj.org/toc/1471-2369Abstract Background Few data is available on the risk/benefit balance of native kidney biopsy (KB) in very elderly patients. Methods Multicenter retrospective cohort study in the Aix-Marseille area: the results of KB and medical charts of all patients over 85 years biopsied between January 2010 and December 2018 were reviewed. Results 104 patients were included. Median age was 87 years. Indications for KB were: acute kidney injury (AKI) in 69.2% of patients, nephrotic syndrome (NS) with AKI in 13.5%, NS without AKI in 12.5%, and proteinuria in 4.8%. Median serum creatinine was 262 μmol/L, 21% of patients required dialysis at the time of KB. Significant bleeding occurred in 7 (6.7%) patients, requiring blood cell transfusion in 4 (3.8%), and radiological embolization in 1 (1%). The most frequent pathological diagnoses were: non-diabetic glomerular diseases (29.8%, including pauci-immune crescentic glomerulonephritis in 9.6%), hypertensive nephropathy (27.9%), acute interstitial nephritis (16.3%), renal involvement of hematological malignancy (8.7%), and acute tubular necrosis (6.7%). After KB, 51 (49%) patients received a specific treatment: corticosteroids (41.3%), cyclophosphamide (6.7%), rituximab (6.7%), bortezomib (3.8%), other chemotherapies (3.8%). Median overall survival was 31 months. Conclusions KB can reveal a diagnosis with therapeutic impact even in very elderly patients. Severe bleeding was not frequent in this cohort, but KB may have not been performed in more vulnerable patients.Mathilde FediMickaël BobotJulia TorrentsPierre GobertÉric MagnantYannick KnefatiDavid VerhelstGaëtan LebrunValérie MassonPhilippe GiaimeJulien SantiniStanislas BataillePhilippe BrunetBertrand DussolStéphane BurteyJulien ManciniLaurent DanielNoémie Jourde-ChicheBMCarticleKidney biopsyElderly patientAdvanced ageAcute kidney injuryNephrotic syndromeGlomerulonephritisDiseases of the genitourinary system. UrologyRC870-923ENBMC Nephrology, Vol 22, Iss 1, Pp 1-9 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Kidney biopsy Elderly patient Advanced age Acute kidney injury Nephrotic syndrome Glomerulonephritis Diseases of the genitourinary system. Urology RC870-923 |
| spellingShingle |
Kidney biopsy Elderly patient Advanced age Acute kidney injury Nephrotic syndrome Glomerulonephritis Diseases of the genitourinary system. Urology RC870-923 Mathilde Fedi Mickaël Bobot Julia Torrents Pierre Gobert Éric Magnant Yannick Knefati David Verhelst Gaëtan Lebrun Valérie Masson Philippe Giaime Julien Santini Stanislas Bataille Philippe Brunet Bertrand Dussol Stéphane Burtey Julien Mancini Laurent Daniel Noémie Jourde-Chiche Kidney biopsy in very elderly patients: indications, therapeutic impact and complications |
| description |
Abstract Background Few data is available on the risk/benefit balance of native kidney biopsy (KB) in very elderly patients. Methods Multicenter retrospective cohort study in the Aix-Marseille area: the results of KB and medical charts of all patients over 85 years biopsied between January 2010 and December 2018 were reviewed. Results 104 patients were included. Median age was 87 years. Indications for KB were: acute kidney injury (AKI) in 69.2% of patients, nephrotic syndrome (NS) with AKI in 13.5%, NS without AKI in 12.5%, and proteinuria in 4.8%. Median serum creatinine was 262 μmol/L, 21% of patients required dialysis at the time of KB. Significant bleeding occurred in 7 (6.7%) patients, requiring blood cell transfusion in 4 (3.8%), and radiological embolization in 1 (1%). The most frequent pathological diagnoses were: non-diabetic glomerular diseases (29.8%, including pauci-immune crescentic glomerulonephritis in 9.6%), hypertensive nephropathy (27.9%), acute interstitial nephritis (16.3%), renal involvement of hematological malignancy (8.7%), and acute tubular necrosis (6.7%). After KB, 51 (49%) patients received a specific treatment: corticosteroids (41.3%), cyclophosphamide (6.7%), rituximab (6.7%), bortezomib (3.8%), other chemotherapies (3.8%). Median overall survival was 31 months. Conclusions KB can reveal a diagnosis with therapeutic impact even in very elderly patients. Severe bleeding was not frequent in this cohort, but KB may have not been performed in more vulnerable patients. |
| format |
article |
| author |
Mathilde Fedi Mickaël Bobot Julia Torrents Pierre Gobert Éric Magnant Yannick Knefati David Verhelst Gaëtan Lebrun Valérie Masson Philippe Giaime Julien Santini Stanislas Bataille Philippe Brunet Bertrand Dussol Stéphane Burtey Julien Mancini Laurent Daniel Noémie Jourde-Chiche |
| author_facet |
Mathilde Fedi Mickaël Bobot Julia Torrents Pierre Gobert Éric Magnant Yannick Knefati David Verhelst Gaëtan Lebrun Valérie Masson Philippe Giaime Julien Santini Stanislas Bataille Philippe Brunet Bertrand Dussol Stéphane Burtey Julien Mancini Laurent Daniel Noémie Jourde-Chiche |
| author_sort |
Mathilde Fedi |
| title |
Kidney biopsy in very elderly patients: indications, therapeutic impact and complications |
| title_short |
Kidney biopsy in very elderly patients: indications, therapeutic impact and complications |
| title_full |
Kidney biopsy in very elderly patients: indications, therapeutic impact and complications |
| title_fullStr |
Kidney biopsy in very elderly patients: indications, therapeutic impact and complications |
| title_full_unstemmed |
Kidney biopsy in very elderly patients: indications, therapeutic impact and complications |
| title_sort |
kidney biopsy in very elderly patients: indications, therapeutic impact and complications |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/7defd54093a145f3a9c5a3be4a1445c6 |
| work_keys_str_mv |
AT mathildefedi kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT mickaelbobot kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT juliatorrents kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT pierregobert kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT ericmagnant kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT yannickknefati kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT davidverhelst kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT gaetanlebrun kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT valeriemasson kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT philippegiaime kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT juliensantini kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT stanislasbataille kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT philippebrunet kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT bertranddussol kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT stephaneburtey kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT julienmancini kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT laurentdaniel kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications AT noemiejourdechiche kidneybiopsyinveryelderlypatientsindicationstherapeuticimpactandcomplications |
| _version_ |
1718442253926531072 |