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Vasculitis and rapidly progressive glomerulonephritis in the elderly

R M Higgins1, D J Goldsmith, J Connolly

  • 1Department of Renal Medicine, King's College Hospital, London, UK.

Postgraduate Medical Journal
|January 1, 1996
PubMed
Summary

Elderly patients (70+) with vasculitis and rapidly progressive glomerulonephritis benefit from chemotherapy. Early diagnosis via renal biopsy and prompt treatment improve survival and reduce dialysis dependence in this growing patient group.

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Area of Science:

  • Nephrology
  • Geriatric Medicine
  • Immunology

Background:

  • The incidence of vasculitis and rapidly progressive glomerulonephritis in patients aged 70 years and over has significantly increased.
  • Older adults represent a growing demographic affected by these conditions, necessitating specific clinical evaluation.

Purpose of the Study:

  • To investigate the clinical presentation and outcomes of elderly patients (≥70 years) diagnosed with vasculitis and rapidly progressive glomerulonephritis.
  • To assess the impact of immunosuppressive therapy on the survival and renal function of older patients with these conditions.

Main Methods:

  • Retrospective analysis of 56 patients presenting with vasculitis and rapidly progressive glomerulonephritis at two renal units.
  • Evaluation of patient demographics, clinical presentation (including creatinine levels and dialysis status), treatment response, and survival rates.

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  • Analysis of factors influencing patient outcomes, such as comorbidities and remission status.

    • Main Results:

    • 30% (17 of 56) of the studied patients were aged 70 years or over, presenting with a mean creatinine of 530 μmol/l, with five requiring dialysis.
    • Patient survival at one and two years was 62.5% and 50%, respectively.
    • 90% and 100% of surviving patients were dialysis-independent at one and two years, respectively, with chemotherapy showing an excellent response and no treatment-related deaths.

    Conclusions:

    • Diagnosis of vasculitis and rapidly progressive glomerulonephritis in elderly patients via renal biopsy is crucial.
    • Administration of chemotherapy, including cyclophosphamide, offers significant benefits, improving survival and renal function in older adults.
    • Despite comorbidities, elderly patients with these conditions can achieve worthwhile benefits from timely diagnosis and treatment.