Imperial College London
Alternate

PROFESSOR H. TERENCE COOK

Faculty of Medicine, Department of Immunology and Inflammation

Emeritus Professor
 
 
 
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Contact

 

+44 (0)20 3313 2009t.h.cook

 
 
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Assistant

 

Miss Claudia Rocchi +44 (0)20 3313 2315

 
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Location

 

9N9Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Navaratnarajah:2019:ckj/sfz006,
author = {Navaratnarajah, A and Sambasivan, K and Cook, TH and Pusey, C and Roufosse, C and Willicombe, M},
doi = {ckj/sfz006},
journal = {Clinical Kidney Journal},
pages = {512--520},
title = {Predicting long-term renal and patient survival by clinicopathological features in elderly patients undergoing a renal biopsy in a UK cohort},
url = {http://dx.doi.org/10.1093/ckj/sfz006},
volume = {12},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Several publications have demonstrated the use of renal biopsy in elderly patients in establishing a diagnosis and enabling directed therapy. However, evidence on the long-term outcomes following biopsies is lacking. The aim of this study is to describe the renal and patient outcomes in elderly patients according to indication for biopsy, clinical parameters and the histological diagnosis. Methods: We performed a retrospective cohort study of 463 patients >70 years old who underwent a renal biopsy at our centre between 2006 and 2015. Results: The median age of the patients was 74.8 (range 70.0-89.6) years. The most frequent primary diagnoses were pauci-immune crescentic glomerulonephritis (GN; 12%), acute interstitial nephritis (10.8%) and membranous GN (7.1%). Death-censored renal survival at 1 and 5 years following the index biopsy was 85.2 and 75.9%, respectively, and patient survival at 1 and 5 years was 92.2 and 71.6%, respectively. Patients who progressed to end-stage renal disease (ESRD) were at higher risk of dying compared with patients who did not require dialysis [hazard ratio 2.41 (95% confidence interval 1.58-3.68; P < 0.001]. On multivariate analysis, factors associated with the risk of progression to ESRD were creatinine (P < 0.001), heavy proteinuria (P = 0.002) and a non-chronic kidney disease (CKD) biopsy indication (P = 0.006). A histological diagnosis of primary GN (P = 0.001) or tubulointerstitial nephritis (P = 0.008) was associated with a favourable renal outcome, while patients with vasculitis and paraprotein-related renal disease (PPRD) had the highest risk of requiring dialysis (P = 0.0002 and P = 0.003, respectively). PPRD was also an independent risk factor for death. Conclusions: This study demonstrates that renal biopsies in the elderly not only enable directed therapy, but also provide prognostic i
AU  - Navaratnarajah,A
AU  - Sambasivan,K
AU  - Cook,TH
AU  - Pusey,C
AU  - Roufosse,C
AU  - Willicombe,M
DO  - ckj/sfz006
EP  - 520
PY  - 2019///
SN  - 2048-8505
SP  - 512
TI  - Predicting long-term renal and patient survival by clinicopathological features in elderly patients undergoing a renal biopsy in a UK cohort
T2  - Clinical Kidney Journal
UR  - http://dx.doi.org/10.1093/ckj/sfz006
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31384442
UR  - http://hdl.handle.net/10044/1/74434
VL  - 12
ER  -
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