Korean Journal of Nephrology 1996;15(4):485-496.
노인의 사구체신염
오국환 , 박정환 , 이상구 , 허우성 , 윤형진 , 안규리 , 한진석, 김성권 , 이정상
Abstract
Little is known so far about the clinicopathologi- cal feature of glomerulonephritis in the elderly. This study is aimed at overviewing the clinical and pa- thological characteristics of the glomerulonephritis (GN) in the elderly whose ages are equal to or over 60 in comparison with the younger GN patients. We have retrospectively reviewed 67 elderly patients who were subjected to renal biopsy from 1979 to 1993 under the clinical impression of glomerulonep- hritis(45 male and 22 female). All the patients were reviewed in the clinical aspects upon hypertension, azotemia, hematuria, hepatitis s antigenemia. Patho- logic diagnoses were made according to the clas- sification by Churg. Our total renal biopsies were 52 primary and 15 secondary glomerulonephritis(3.5:1) Our cases of pri- mary GN were membraneous nephropathy(MN, 28.8%), minimal change lesion(MCL,23.1%), focal glomerulosclerosis(9.6%), sclerosing GN(9.6%), IgA nephropathy(7.7%), membranoproliperative GN(7.7%), crescentic GN(7.7%) and diffuse endocapillary proli- ferative GN(1.9%) in the descending order of frequency Compared with the 1,923 contemporary biopsies from younger adult patients, MN, crescentic GN, renal amyloidosis and thrombotic thrombocy- topenic purpura were significantly more prevalent in elderly patients(p<0.05). Nephrotic syndrome was the single most frequent mode of clinical presentation. MCL was the second most common pathology among the elderly, showing excellent prognosis. This sup- ports our strategy of aggressive diagnostic work-up and treatment for the elderly GN patients. The overall distribution of the elderly GN is not much different from that of the younger, except for a few diseases. Aggressive diagnostic and thera- peutic approaches are desired for the elderly GN pa- tients.
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