Glomerular diseases in the elderly in India

Area of Science:

• Nephrology
• Geriatric Medicine
• Pathology

Background:

• Glomerular diseases (GN) are a significant cause of renal morbidity in the elderly.
• Understanding the spectrum of GN in elderly populations is crucial for effective management.

Purpose of the Study:

• To evaluate the prevalence and characteristics of glomerular diseases in elderly patients with clinical renal diseases.
• To compare the spectrum of GN in the Indian elderly population with that reported in Western countries.

Main Methods:

• Retrospective analysis of 315 elderly patients (>= 60 years) with clinical renal diseases from November 1998 to June 2002.
• Clinical presentation, laboratory findings, and renal biopsy data were reviewed.
• Classification of GN into primary/secondary and specific histopathological types.

Main Results:

• Glomerular diseases were diagnosed in 20.6% of elderly patients.
• Nephrotic syndrome (61.5%) and acute nephritic syndrome (29.2%) were the most common presentations.
• Idiopathic membranous nephropathy was the most frequent cause of nephrotic syndrome, followed by diabetic nephropathy.
• Post-infectious endocapillary proliferative GN was the most prevalent form of acute GN, unlike the rarity of pauci-immune crescentic GN.
• Hypertension (78.2%) and edema (69.5%) were common clinical features; 73.9% presented with acute renal failure (ARF), and 39% required dialysis.

Conclusions:

• The spectrum of glomerular diseases in the Indian elderly is similar to developed countries, with notable differences in the predominant type of acute GN.
• Post-infectious GN is a significant cause of acute GN in this population.
• The rarity of pauci-immune crescentic GN in this study contrasts with its prevalence in Western elderly populations.