NEPHROTIC SYNDROME
Posted by admin on July 29th, 2010Traditionally, age was thought to play an important role in the pathogenesis of nephrotic syndromes (eg, the likelihood of minimal-change disease decreases and that of amyloidosis increases with age). However, clinical und biopsy data from a large number of elderly nephrotic patients now indicate that, in general, age has no impact on the frequency of any pathologic glomerular change.
The most common nephrotic lesion in old age is membranous glomerulonephritis; the second most common is minimal-change disease. Membranous glomerulonephritis is often associated with carcinoma of the lung, colon, or stomach. Nonsteroidal anti-inflammatory drugs are emerging as an important preventable cause of nephrotic syndrome in
the elderly.
Elderly patients with minimal-change disease generally have an excellent response to corticosteroids and immunosuppressants. In addition, some elderly patients with membranous glomerulonephritis respond to corticosteroid or cyclophosphamide therapy. In many cases.
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