The nephrotic syndrome in adults aged over 60: etiology, evolution and treatment of 76 cases

A study of the clinical, etiological and histological features of the nephrotic syndrome occurring in 76 adults aged over 60 was performed. Membranous nephropathy was the most frequent type (40%). 32% of the cases of membranous nephropathy were associated with another disease which was a malignant one in 22% of the cases. In 2 cases a renal vein thrombosis was associated with the malignant disease. Amyloidosis appeared to be the most frequent cause of the secondary nephrotic syndrome (13%), and was often associated with plasma cell dyscrasia. The study also showed the importance of lipoid nephrosis among elderly patients with the nephrotic syndrome (20%). Amongst these cases it is necessary to consider the association of minimal changes with a systemic disease, and the histological diagnosis of focal hyalinosis. Indeed the presence in elderly patients of arteriolar, interstitial and glomerular lesions of hyalinosclerosis makes interpretation difficult. With corticosteroid therapy complete remission was frequent in patients with lipoid nephrosis.