Characteristics and outcome of membranous nephropathy in older patients

Many patients with idiopathic membranousnephropathy are elderly, but little is knownabout the natural or treated history of thesepatients. We have studied a cohort of 155patients with membranous nephropathy who wererecruited and followed up over a 20 yearperiod. We have compared the clinical featuresand outcome of the older (>60 years) andyounger age groups.There was a higher incidence of an identifiablecause for the nephropathy in older patients. Atpresentation with idiopathic disease, olderpatients were more often hypertensive and hadworse renal impairment than the younger cohort,but had a similar levels of proteinuria,hypoalbuminemia and hematuria. Thromboticcomplications and minor rheumatologicalcomplaints were more common in the olderpatients. Prognosis for life and renal survivalwas worse in the older onset patients.Treatment was well tolerated in selected olderpatients and was associated with a betteroutcome in those selected for treatment.