Use of renal biopsy in the elderly

Renal biopsy is an essential tool in the management of kidney disease. A biopsy provides a diagnosis, guides therapy and aids in prognosis, and this is true for persons of all ages. For a variety of reasons, nephrologists are sometimes hesitant to perform a biopsy in an older person. There is the major issue of a lack of perceived benefit that the biopsy will not show a treatable lesion and that therapy may not be possible in an older person. Additionally, concerns of safety may also influence the decision to biopsy. In this review, we will address these issues in the context of clinical renal syndromes and common kidney diseases in the elderly and weigh the benefit of biopsy in various situations. In general, the indications are the same as in the adult population, as is the risk associated with the biopsy procedure. Therapy, as for adults, is often successful, although further assessment of risk-benefit ratio is necessary. Age, by itself, is not a contraindication to biopsy.