Dialyse aktuell 2015; 19(6): 304-308
DOI: 10.1055/s-0035-1562919
Nephrologie
© Georg Thieme Verlag Stuttgart · New York

Nierenbiopsien – Histologische Veränderungen bei älteren Patienten

Renal biopsies – Histological changes in elderly patients
Maike Büttner-Herold
1   Nephropathologische Abteilung, Pathologisches Institut, Universität Erlangen-Nürnberg, Erlangen (Abteilungsleiterin: Prof. Dr. Kerstin Amann)
,
Kerstin Amann
1   Nephropathologische Abteilung, Pathologisches Institut, Universität Erlangen-Nürnberg, Erlangen (Abteilungsleiterin: Prof. Dr. Kerstin Amann)
› Author Affiliations
Further Information

Publication History

Publication Date:
10 August 2015 (online)

Zusammenfassung

Nierenerkrankungen älterer Patienten stellen aufgrund der epidemiologischen Entwicklung ein zunehmendes klinisches Problem dar. Wie bei jüngeren Patienten stellt auch bei älteren, komorbiden Patienten die Nierenbiopsie den Goldstandard der Diagnostik einer Nierenerkrankung, und hier v.a. der Glomerulonephritiden, dar. Dies umso mehr, als sich die Durchführung und Komplikationsrate der Nierenbiopsie bei älteren Patienten nicht von derjenigen jüngerer Patienten unterscheidet und auch die Befunde und deren therapeutische und prognostische Konsequenzen durchaus vergleichbar sind. Insofern ist es wichtig und sinnvoll, bei entsprechender Indikation gerade auch bei älteren Patienten zeitnah eine Nierenbiopsie anzustreben.

Summary

Renal disease in elderly patients is an increasing clinical problem. As in younger patients with renal disease, kidney biopsy is the gold standard to diagnose renal disease, particulary glomerular disease, even more important since neither the performance nor the complication rate of a kidney biopsy in elderly patients is different from that in younger patients. Moreover, histological findings and in particular their therapeutical and prognostical consequences are also comparable. Thus, if there is a clear indication it makes enormous sense and is particularly important in elderly patients to aim for an immediate kidney biopsy.

 
  • Literatur

  • 1 Rivera F, Lopez-Gomez JM, Perez-Garcia R. Spanish Registry of Glomerulonephritis. Clinicopathologic correlations of renal pathology in Spain. Kidney Int 2004; 66: 898-904
  • 2 Nair R, Bell JM, Walker PD. Renal biopsy in patients aged 80 years and older. Am J Kidney Dis 2004; 44: 618-626
  • 3 Shin JH, Pyo HJ, Kwon YJ et al. Renal biopsy in elderly patients: clinicopathological correlation in 117 Korean patients. Clin Nephrol 2001; 56: 19-26
  • 4 Vendemia F, Gesualdo L, Schena FP, D'Amico G. Renal Immunopathology Study Group of the Italian Society of Nephrology. Epidemiology of primary glomerulonephritis in the elderly. Report from the Italian Registry of Renal Biopsy. J Nephrol 2001; 14: 340-352
  • 5 Jefferson JA, Alpers CE. Diagnosis: should renal biopsies be performed in the very elderly?. Nat Rev Nephrol 2009; 5: 561-562
  • 6 Moran D, Korzets Z, Bernheim J et al. Is renal biopsy justified for the diagnosis and management of the nephrotic syndrome in the elderly?. Gerontology 1993; 39: 49-54
  • 7 Moorthy AV, Zimmerman SW. Renal disease in the elderly: clinicopathologic analysis of renal disease in 115 elderly patients. Clin Nephrol 1980; 14: 223-229
  • 8 Kingswood JC, Banks RA, Tribe CR et al. Renal biopsy in the elderly: clinicopathological correlations in 143 patients. Clin Nephrol 1984; 22: 183-187
  • 9 Haas M, Spargo BH, Wit EJ, Meehan SM. Etiologies and outcome of acute renal insufficiency in older adults: a renal biopsy study of 259 cases. Am J Kidney Dis 2000; 35: 433-447
  • 10 Ferro G, Dattolo P, Nigrelli S et al. Clinical pathological correlates of renal biopsy in elderly patients. Clin Nephrol 2006; 65: 243-247
  • 11 Preston RA, Stemmer CL, Matterson BJ et al. Renal biopsy in patients 65 years of age or older. An analysis of the results of 334 biopsies. J Am Geriatr Soc 1990; 38: 669-674
  • 12 Komatsuda A, Nakamoto Y, Imai H et al. Kidney diseases among the elderly. A clinicopathological analysis of 247 elderly patients. Inter Med 1993; 32: 377-381
  • 13 Davison AM, Johnston PA. Glomerulonephritis in the elderly. Nephrol Dial Transplant 1996; 11: 34-37
  • 14 Moutzouris DA, Herlitz L, Appel GB et al. Renal biopsy in the very elderly. Clin J Am Soc Nephrol 2009; 4: 1073-1082
  • 15 Rule AD, Cornell LD, Poggio ED. Semile Nephrosclerosis--does it explain the decline in GFR with age?. Nephron Physiol 2011; 119 (Suppl. 1): 6-11
  • 16 Yang H, Fogo AB. Cell senescence in the aging kidney. J Am Soc Nephrol 2010; 21: 1436-1439
  • 17 McLachlan MS. The ageing kidney. Lancet 1978; 2: 143-145
  • 18 Verde E, Quiroga B, Rivera F, Lopez-Gomez JM. Renal biopsy in very elderly patients: data from the Spanish registry of glomerulonephritis. Am J Nephrol 2012; 35: 230-237
  • 19 Yang F, Li B, Cui W et al. A clinicopathological study of renal biopsies from 288 elderly patients: analysis based on 4,185 cases. Int Urol Nephrol 2015; 47: 327-333
  • 20 Dhaun N, Bellamy CO, Cattran DC, Kluth DC. Utility of renal biopsy in the clinical management of renal disease. Kidney Int 2014; 85: 1039-1048