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NATIVE RENAL BIOPSY : DATA REGARDING THE 2016 INDICATED BIOPSIES IN A PRIVATE HEALTH CARE PROVIDER, SPECIALIST IN CUSTOMER SERVICE IN ELDERLY PEOPLE IN BRAZIL

INTRODUCTION AND AIMS: Data related to native renal biopsy in the elderly (age > 60 yr) has been published more often in the last 5 years, but are still limited. In Brazil this is even worse. The aim of this study was to analyze the indications and results of the native renal biopsies indicated during 2016 in a population of elderly patients in the city of São Paulo (Brazil), that use a private health care provider system, as one of the firsts studies in the country.

METHODS: Data of all the patients that had native renal biopsies indicated during 2016 (n = 60) was retrospectively analyzed, including gender, age, comorbidities, laboratory exams, suspected diagnoses, when biopsy was indicated, and its result.

RESULTS: Of the 60 patients with biopsy indicated in this year, most of them were men (36 vs. 24 women). The mean age was 70.13 years. Hypertension (HTN), mellitus diabetes type II (MD) and previous use of tobacco were the most common comorbidities (75.00%, 43.33% and 30.00%, respectively). Proteinuria (PTN) and nephrotic syndrome (NS), together, was the most common causes of biopsy indications (45.00% - 25.00% and 20.00%, if separately analyzed) followed by renal neoplasia suspicion (25.00%). Despite the indication, 25.00% of the patients did not realized the procedure. Regarding the 45 realized biopsies, the most frequent diagnoses was Focal Segmental Glomerulosclerosis (FSGS) in 24.44% of the cases, including secondary to hypertension in 15.56% and the ones that were not classified as primary or secondary in 8.89%. The second most frequent biopsy diagnoses were Membranous Glomerulonephritis and Diabetic Nephropathy (11.11% each), followed by Clear Cell Renal Cell Carcinoma (8.89%). The most common etiologies considering NS and PTN was diabetic nephropathy and FSGS secondary to HTN (20% and 38,46%, respectively). Renal biopsies specimens were not sufficient to determine diagnoses in 6.67% of the cases.

CONCLUSIONS: Our results differ in comparison with many other articles already published worldwide, what contributes with the scientific community in the country. This study did not aim to determine why the results were different at this moment, at least. Although its indication is not as common as it should be, native renal biopsy in the elderly is a valuable tool during the diagnosis and treatment process.