Is Renal Biopsy Justified for the Diagnosis and Management of the Nephrotic Syndrome in the Elderly?

Gerontology ◽  
1993 ◽  
Vol 39 (1) ◽  
pp. 49-54 ◽  
Author(s):  
D. Moran ◽  
Z. Korzets ◽  
J. Bernheim ◽  
J. Bernheim ◽  
A. Yaretzky
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
The Elderly ◽  
Diagnosis And Management

Minimal change disease

2019 ◽  
pp. 175-224
Author(s):  
Claudio Ponticelli ◽  
Richard J Glassock ◽  
Rosanna Coppo
Keyword(s):  
Electron Microscopy ◽  
Nephrotic Syndrome ◽  
Light Microscopy ◽  
Renal Biopsy ◽  
Minimal Change Disease ◽  
The Elderly ◽  
Minimal Change ◽  
Common Cause ◽  
Foot Process

This chapter discusses minimal change disease (MCD), which is chiefly characterized clinically by episodes of nephrotic syndrome (NS) and presents with massive proteinuria, hypo-albuminaemia, hyperlipidaemia, and generalized oedema, Morphologically, it is characterized by no or only minimal glomerular abnormalities in a renal biopsy examined by light microscopy and immunofluorescence, while there is diffuse effacement of the podocyte foot process by electron microscopy. MCD is the most common cause of NS in children but it may also develop at any age, including in the elderly. This chapter covers the pathology, presentation, and treatment of MCD, including practical tips for the practitioner.

A case of minimal change disease during pregnancy – Benefits of early diagnosis and use of corticosteroids

2021 ◽  
pp. 1753495X2199021
Author(s):  
Priyanka S Sagar ◽  
Eddy Fischer ◽  
Muralikrishna Gangadharan Komala ◽  
Bhadran Bose
Keyword(s):  
Nephrotic Syndrome ◽  
Early Diagnosis ◽  
Renal Biopsy ◽  
Early Pregnancy ◽  
Minimal Change Disease ◽  
Minimal Change ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Prompt Diagnosis ◽  
In Pregnancy

Nephrotic syndrome presenting in pregnancy is rare and poses a diagnostic and therapeutic challenge. Timing of renal biopsy is important given the increased risk of bleeding and miscarriage, and the choice of immunosuppression is limited due to the teratogenicity profiles of standard drugs. We report and discuss a case of minimal change disease diagnosed by renal biopsy during early pregnancy and treated with corticosteroids throughout the pregnancy. Prompt diagnosis and treatment of glomerular disease in pregnancy are vital to prevent poor maternal and fetal outcomes.

scholarly journals Clinical manifestations of focal segmental glomerulosclerosis in Japan from the Japan Renal Biopsy Registry: age stratification and comparison with minimal change disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takaya Ozeki ◽  
Shoichi Maruyama ◽  
Toshiyuki Imasawa ◽  
Takehiko Kawaguchi ◽  
Hiroshi Kitamura ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Clinical Diagnosis ◽  
Clinical Characteristics ◽  
Minimal Change Disease ◽  
Multivariable Analysis ◽  
Laboratory Data ◽  
Minimal Change ◽  
Segmental Glomerulosclerosis

AbstractFocal segmental glomerulosclerosis (FSGS) is a serious condition leading to kidney failure. We aimed to investigate the clinical characteristics of FSGS and its differences compared with minimal change disease (MCD) using cross-sectional data from the Japan Renal Biopsy Registry. In Analysis 1, primary FSGS (n = 996) were stratified by age into three groups: pediatric (< 18 years), adult (18–64 years), and elderly (≥ 65 years), and clinical characteristics were compared. Clinical diagnosis of nephrotic syndrome (NS) was given to 73.5% (97/132) of the pediatric, 41.2% (256/622) of the adult, and 65.7% (159/242) of the elderly group. In Analysis 2, primary FSGS (n = 306) and MCD (n = 1303) whose clinical diagnosis was nephrotic syndrome (NS) and laboratory data were consistent with NS, were enrolled. Logistic regression analysis was conducted to elucidate the variables which can distinguish FSGS from MCD. On multivariable analysis, higher systolic blood pressure, higher serum albumin, lower eGFR, and presence of hematuria associated with FSGS. In Japanese nationwide registry, primary FSGS patients aged 18–64 years showed lower rate of NS than those in other ages. Among primary nephrotic cases, FSGS showed distinct clinical features from MCD.

scholarly journals Adult onset Still’s disease in the elderly: a case-based literature review

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Arash Mollaeian ◽  
Jingjing Chen ◽  
Nina N. Chan ◽  
Gregory A. Nizialek ◽  
Christopher J. Haas
Keyword(s):  
Delayed Diagnosis ◽  
The Elderly ◽  
Adult Onset Still’S Disease ◽  
Inflammatory Disorder ◽  
Adult Onset ◽  
Still’S Disease ◽  
Diagnosis And Management ◽  
Still's Disease ◽  
Area Of Interest ◽  
Adult Onset Still's Disease

Abstract Background Adult onset Still’s disease (AOSD) is a rare inflammatory disorder that classically presents with high spiking fevers, evanescent rash, and arthritis. The diagnosis is one of exclusion and can be further complicated by atypical presentations, particularly in elderly patients in whom AOSD is very rare. Case presentation A case of AOSD in a 73-year-old woman with a non-classic presentation, leading to delayed diagnosis and management, is presented along with a review of the English literature for AOSD cases in elderly people over 70 years of age. Thirty nine case reports and series were identified and the current case was added, totaling 42 individual cases. Significant findings included a four-times higher prevalence in females, a higher prevalence of macrophage activation syndrome despite lower mortality, the presence of pruritic rash in almost one fifth of the cases, and high prevalence of delayed diagnosis. Conclusions AOSD in the elderly may vary from the classic criteria described in the medical literature and may lead to delayed diagnosis and management. Further evaluation and better characterization of AOSD in the elderly remains an area of interest.

RENAL AMYLOIDOSIS RESULTING FROM A CHRONICALLY INFECTED BURN

PEDIATRICS ◽  
1963 ◽  
Vol 32 (5) ◽  
pp. 888-894
Author(s):  
Saul Hoffman ◽  
Bernard E. Simon ◽  
Robert A. Fischel ◽  
Donald Gribetz
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
Clinical Improvement ◽  
Short Duration ◽  
Unusual Case ◽  
White Male ◽  
Lower Extremities ◽  
Renal Amyloidosis ◽  
One Year

An interesting and unusual case of an 11-year-old white male with chronically infected burns of his lower extremities who developed amyloidosis and the nephrotic syndrome is reported. The case is considered from the following aspects: (1) the rarity of amyloidosis in burns, (2) the short duration between the onset of the primary disease and the amyloidosis, (3) the age of the patient, and (4) the striking clinical improvement of the renal manifestations after the treatment of the burn. The treatment of the burns, using homografts, and the importance of renal biopsy in the diagnosis and follow-up are also discussed. Addendum: A third renal biopsy was performed in August, 1963, about one year following the second one. The amount of amyloid seen in the glomeruli did not seem to have diminished.

RENAL HISTOLOGY DURING TREATMENT WITH OXAZOLIDINE-DIONES (TRIMETHADIONE, ETHADIONE, AND PARAMETHADIONE)

PEDIATRICS ◽  
1962 ◽  
Vol 30 (4) ◽  
pp. 601-607
Author(s):  
A. Bergstrand ◽  
C. G. Bergstrand ◽  
N. Engström ◽  
K. M. Herrlin
Keyword(s):  
Electron Microscopy ◽  
Nephrotic Syndrome ◽  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Present Knowledge ◽  
Short Report ◽  
Renal Histology ◽  
Renal Changes

Seven patients with petit mal seizures treated with trimethadione, ethadione, or paramethadione for long periods were subjected to renal biopsy at the age of 14½ 16½ years. None of the patients had clinical signs of renal disease at the time of the biopsy, but three of them had previously shown transient hematuria or proteinuria. The renal histology was studied by conventional methods and by electron microscopy, the latter method only including the glomeruli. The changes found must with the present knowledge be regarded as physiological. A short report is given of a patient with phenylketonuria and epilepsy who developed a nephrotic syndrome during treatment with tridione. No definite pathologic renal changes were demonstrated at the when the clinical symptoms had disappeared.

Should a renal biopsy be performed at the first relapse of ‘clinical nephrotic syndrome’?

2008 ◽  
Vol 42 (2) ◽  
pp. 184-186
Author(s):  
Pietro Ferrara ◽  
Antonio Mastrangelo ◽  
Alessandro Nicoletti ◽  
Antonio Gatto ◽  
Valerio Gaetano Vellone ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
First Relapse
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