Renal disease in the elderly and the very elderly Japanese: analysis of the Japan Renal Biopsy Registry (J-RBR) View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-10-11

AUTHORS

Hitoshi Yokoyama, Hitoshi Sugiyama, Hiroshi Sato, Takashi Taguchi, Michio Nagata, Seiichi Matsuo, Hirofumi Makino, Tsuyoshi Watanabe, Takao Saito, Yutaka Kiyohara, Shinichi Nishi, Hiroyuki Iida, Kunio Morozumi, Atsushi Fukatsu, Tamaki Sasaki, Kazuhiko Tsuruya, Yukimasa Kohda, Makoto Higuchi, Hideyasu Kiyomoto, Shin Goto, Motoshi Hattori, Hiroshi Hataya, Shoji Kagami, Norishige Yoshikawa, Yuichiro Fukasawa, Yoshihiko Ueda, Hiroshi Kitamura, Akira Shimizu, Kazumasa Oka, Naoki Nakagawa, Takafumi Ito, Shunya Uchida, Kengo Furuichi, Izaya Nakaya, Satoshi Umemura, Keiju Hiromura, Mitsuhiro Yoshimura, Nobuhito Hirawa, Takashi Shigematsu, Masafumi Fukagawa, Makoto Hiramatsu, Yoshio Terada, Osamu Uemura, Tetsuya Kawata, Akira Matsunaga, Aki Kuroki, Yasukiyo Mori, Koji Mitsuiki, Haruyoshi Yoshida

ABSTRACT

Background and objectivesData 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 measurementsFrom 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.ResultsThe 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.ConclusionsRenal 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. More... »

PAGES

903-920

Journal

TITLE

Clinical and Experimental Nephrology

ISSUE

6

VOLUME

16

Author Affiliations

  • Division of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, 920-0293, Uchinada, Ishikawa, Japan
  • Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
  • Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
  • Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  • Department of Pathology, University of Tsukuba, Faculty of Medicine, Tsukuba, Japan
  • Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Department of Nephrology, Hypertension, Diabetology, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
  • Division of Nephrology & Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
  • Department of Environmental Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
  • Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
  • Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
  • Japanese Red Cross Nagoya Daini Hospital, Kidney Center, Nagoya, Japan
  • Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
  • Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan
  • Department of Medicine and Clinical Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
  • Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Division of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
  • Division of Integrated Nephrology and Telemedicine, Department of Community Medical Supports, Tohoku Medical Megabank Organization (ToMMo), Tohoku University, Sendai, Japan
  • Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
  • Department of Pediatric Nephrology, Tokyo Women’s Medical University, Tokyo, Japan
  • Department of Nephrology, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
  • Department of Pediatrics, Institute of Health Bioscience, The University of Tokushima Graduate School of Medicine, Tokushima, Japan
  • Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
  • Department of Pathology, Sapporo City Hospital, Sapporo, Japan
  • Department of Pathology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
  • National Hospital Organization Chiba–East National Hospita, Clinical Research Center, Chiba, Japan
  • Department of Pathology, Nippon Medical School, Tokyo, Japan
  • Department of Pathology, Hyogo Prefectural Nisihinomiya Hospital, Nishinomiya, Japan
  • Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University Hospital, Asahikawa, Japan
  • Division of Nephrology, Shimane University Faculty of Medicine, Izumo, Japan
  • Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
  • Division of Nephrology, Kanazawa University Hospital, Kanazawa, Japan
  • Department of Nephrology, Iwate Prefectural Central Hospital, Morioka, Japan
  • Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine and School of Medicine, Yokohama, Japan
  • Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Gumma, Japan
  • Department of Nephrology and Rheumatology, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
  • Yokohama City University Medical Center, Yokohama, Japan
  • Division of Nephrology, Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
  • Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isesaki, Japan
  • Department of Nephrology, Okayama Saiseikai General Hospital, Okayama, Japan
  • Department of Endocrinology, Metabolism and Nephrology, Kochi University, Kochi Medical School, Kochi, Japan
  • Department of Pediatric Nephrology, Aichi Children’s Health and Medical Center, Obu, Japan
  • Department of Nephrology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
  • Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan
  • Division of Nephrology, Showa University School of Medicine, Tokyo, Japan
  • Division of Nephrology, Department of Medicine, Kyoto Prefectural University School of Medicine, Kyoto, Japan
  • Nephrology and Dialysis Center, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
  • Division of Nephrology, Department of General Medicine, University of Fukui, Faculty of Medical Sciences, Fukui, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10157-012-0673-8

    DOI

    http://dx.doi.org/10.1007/s10157-012-0673-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1033628050

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/23053590


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        "description": "Background and objectivesData regarding renal disease in the elderly (age \u226565\u00a0years old) and very elderly (age \u226580\u00a0years 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 measurementsFrom 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\u00a0years 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.ResultsThe indications for biopsy were nephrotic syndrome (NS) in 36.2 and 50.7\u00a0% of the elderly and the very elderly patients, chronic nephritic syndrome in 31.8 and 17.4\u00a0%, and acute kidney injury including rapidly progressive glomerulonephritis in 18.6 and 22.5\u00a0%, 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\u00a0<\u00a00.001), and IgAN was less common (P\u00a0<\u00a00.001). 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.ConclusionsRenal 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.", 
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    27 schema:description Background and objectivesData 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 measurementsFrom 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.ResultsThe 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.ConclusionsRenal 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.
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    698 grid-institutes:grid.474861.8 schema:alternateName Department of Nephrology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
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