Renal Biopsy in the Elderly in Senegal: Indications and Outcomes

Introduction: Renal biopsy (RB) is poorly performed in sub-Saharan Africa. It is even less practiced in the elderly. The objective of this study was to determine the indications of RB in the elderly and to describe the histopathological aspects of nephropathies of this age group.

Patients and methods: This is a descriptive retrospective cohort study over a 5-year period (1stJanuary, 2011 to 31stDecember, 2015). Patients older than 60 years who had RB during the study period were included. This RB had to be cortical and contain at least 10 glomeruli. All RB were echoguided.

Results: Of the five hundred and ninety-nine (599) RBs performed, one hundred and five (105) were performed in elderly subjects, for a hospital prevalence of 17%. Only 75 had an interpretable histology. The mean age of the patients was 66.5±5.03 years old. With a sex ratio of 2.4. Nephrotic syndrome was the main indication in 26.7% of cases. Glomerular lesions accounted for 63% of cases, tubulointerstitial lesions 5.2%, vascular lesions 25.36% and unclassified lesions 6.5%. Among the 47 glomerular lesions, there were 13 cases (27.65%) of membranous nephropathy (MN), 12 cases (25.53%) of focal segmental glomerulosclerosis (FSGS), 5 cases (10.63%) of amyloidosis, 4 cases (8.51%) of minimal change disease (MCD), 3 cases (6.38%) of extracapillary glomerulonephritis (EGN), a case (2.12%) of membranoproliferative glomerulonephritis (MPGN) and a case (2.12%) of endocapillary glomerulonephritis.

Conclusion: Our data, similarly to the literature worldwide, shows that MN is the most found lesion in the elderly.

Keywords: renal biopsy, elderly, membranous nephropathy, amyloidosis, Senegal.