Glomerular Disease in the Elderly

Timely diagnosis of primary glomerular diseases in elderly patients could be challenging. Typical clinical presentations of acute glomerular pathology, such as proteinuria and decline of estimated glomerular filtration rate (eGFR), can be seen in the normal aging process and other comorbidities. Acute kidney injury (AKI) is the most common diagnosis for a kidney biopsy, and older age is no longer a contraindication if clinically indicated. Therapeutic approaches are generally similar to the younger adult patients, although clinical data focusing solely on elderly patients remains scarce. Given that weakened immunity from aging may predispose elderly patients to serious infections with immunosuppressants, treatments should be individualized according to baseline physical conditions and other comorbidities. Newer medications with more specific targets and lessened immunosuppression might be of future interest in treating elderly patients with glomerular diseases.