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Membranous glomerulonephritis in the elderly. Is therapy still worthwhile?

  • Review Article
  • Published:
Geriatric Nephrology and Urology

Abstract

The authors review the literature data concerning different aspects of membranous glomerulonephritis (MGN) in the elderly and present a clinical analysis of 32 MGN patients aged more than 65 years followed in their own center.

Regarding pathogenesis, the frequent association with malignancies, drugs and diabetes must be stressed. It is controversial whether age influences the outcome of MGN. Response to treatment is similar in old and in younger patients. However side effects of corticosteroids and immunosuppressive drugs are slightly more frequent in the elderly.

In the authors experience, major biopsy complications were observed in 5% of 115 biopsied patients over 65 years of age (p n.s. vs younger patients). Thirty-two patients were affected with MGN (27.8%). Eighteen old MGN patients received the alternate steroids/chlorambucil course treatment for six months and were compared to 32 MGN patients aged less than 65 years identically treated. Complete remission was achieved in 27.7% of older patients (p n.s. vs younger patients) and partial remission in 38.8% of patients (p n.s.). Minor complications to treatment were observed in 14/18 patients aged more than 65 years and in 15/32 patients aged less than 65 years: the difference was not significant.

In conclusion, this analysis suggests the opportunity to reconsider indication to renal biopsy in old patients, as it is as safe as in the general population. Treatment is advisable, as it can minimize complications of nephrotic syndrome which are risky in old patients, due to a poor tolerance of fluid overload and high frequency of thromboembolism. Complications induced by treatment are slightly more frequent than in the younger population, but can be limited by accurate monitoring of biological parameters and careful examination of the patients.

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Authors and Affiliations

  1. Institute of Nephro-Urology, G. Bosco Hospital, University of Turin, Italy

    Cristiana Rollino M.D., Dario Roccatello, Antonella Vallero, Bruno Basolo & Giuseppe Piccoli

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Rollino, C., Roccatello, D., Vallero, A. et al. Membranous glomerulonephritis in the elderly. Is therapy still worthwhile?. Geriatric Nephrol Urol 5, 97–104 (1995). https://doi.org/10.1007/BF01507841

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