Kidney Biopsy in Older Individuals: Impact on Patient Management, Risks, and Consequences - Single Center Experience

Objective: The incidence of chronic kidney diseases increases in older individuals, like all other chronic diseases. Renal biopsy provides important guidance in the diagnosis of many kidney diseases. The impact of biopsy on patient management in older individuals is controversial. In this study, we evaluated the patient population of over 65 years of age in our clinic in the last decade, biopsy-related complications, and the effects of biopsy results on clinical evaluation. Materials and Methods: Medical records of patients who underwent native kidney biopsies between 2007 and 2018 in our clinic were evaluated. One hundred and fifteen patients were enrolled. The demographic, clinical, and laboratory findings of the patients at the time of biopsy were noted. Effects of renal biopsy on patient management and clinical outcomes, renal biopsy-related complications, and adequate material acquisition rates were noted. Results: Acute kidney injury was the most common renal biopsy indication in older individuals (36.6%). Glomerulonephritis containing crescents was the most common diagnosis (26.8%); 40% (n=12) of this patient group achieved complete remission with immunosuppressive treatment. In approximately two thirds of patients, diagnostic information had the potential to modify treatment (67%). Twenty-four percent of the patients had a diagnosis of malignancy, and the complication rate was 7.1%. Conclusion: Although the complication risk is mildly increased following renal biopsy, valuable clinical information is obtained in a considerable number of patients. Malignancy should be suspected in certain renal diseases in older individuals.