What glomerular diseases are common in the elderly?
Elderly patients presenting with nephritic sediment and acute or rapidly progressive kidney failure often have pauci-immune glomerulonephritis, although anti-glomerular basement membrane and post-infectious glomerulonephritis should also be considered.
A nephrotic presentation, particularly not diabetes related, is commonly associated with membranous glomerulopathy. Although minimal change disease is most common in children, it can be seen in 1 out of 10 older adults with nephrosis. Amyloidosis should also be suspected in older adults with marked proteinuria. Secondary etiologies such as malignancy for these presentations should also be investigated in the older adults given increased association of solid tumors with membranous kidney lesions, Hodgkin and non-Hodgkin lymphoma with minimal change disease, and the presence of paraproteinemia with amyloidosis.
