Abstract: TH-PO633
Clinical Characteristics of Young and Elderly Patients with Minimal Change Nephrotic Syndrome
Session Information
- Membranous Nephropathy, FSGS, and Minimal Change Disease
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Furukawa, Kodai, Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Yamamoto, Shinya, Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Yasugi, Naoko, Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Yokoi, Hideki, Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Yanagita, Motoko, Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Background
The clinical features and favorable response to treatment in young patients with minimal change nephrotic syndrome (MCNS) have been reported. However, clinical differences between young and elderly patients remain unclear.
Methods
We evaluated 17 patients diagnosed with MCNS by renal biopsy between January 2019 and December 2023 at our hospital and divided them into two groups: younger (< 65 years) and elderly (≥ 65 years) patients. We collected clinical deta retrospectively.
Results
Of the 17 patients diagnosed with MCNS on renal biopsy, 8 were elderly and 9 were young, with mean ages of 71.7 (median 71.5) and 36.7 (median 34.0) years, respectively. The number of patients diagnosed with acute kidney injury (AKI) at the time of biopsy was higher in the elderly group (7 in the elderly group (87.5%) and 5 in the young group (55.5%)), of whom 6 (75%) in the elderly group had more severe AKI (> stage 2) and 2 (22.2%) in the young group. There was a significant difference between the young and elderly groups (p < 0.05). All patients received high doses of steroids (> 0.50 mg/kg body weight/day) as initial treatment, and all patients who responded to treatment achieved complete remission, 6 patients (75%) in the elderly group, and all in the young group. The median time to achieve complete remission was significantly longer in the elderly group (28.0 vs. 9.0 days, p <0.05). In patients who achieved complete remission, there was no significant difference in the following oral steroid doses (0.69 vs. 0.75 mg/kg body weight/day) and the mean urine protein-to-creatinine ratio (10.1 vs. 12.3 g/gCr ) at the time of biopsy between the young and elderly groups. The ratios were not significantly different after 12 months of treatment among the 11 patients, excluding 2 elderly patients who underwent dialysis and 3 elderly patients who died during the period due to myocardial infarction, lung cancer, and myelodysplastic syndromes.
Conclusion
We reveal clinical differences between young and elderly patients with MCNS. MCNS in the elderly is associated with more severe AKI and a longer time to achieve complete remission than MCNS in younger patients. When treating elderly patients with MCNS, we should be alert to the complications of steroids and nephrotic syndrome with severe renal impairment, induced by prolonged time to remission.