Clinical and pathological findings and the effects of
therapy were investigated in 90 cases of
nephrotic syndrome (NS) in elderly patients aged over 60 years.
Membranous nephropathy was the most frequent type of primary NS.
Amyloidosis and
malignancy were common causes of secondary NS. Damage to the interstitium in the kidney, such as focal mononuclear cell infiltration,
fibrosis and thickening of the small arterial wall in membranous cases, was often observed. Stage I and II based on electron-microscopy, were mainly observed in the patients, with
membranous nephropathy.
Prednisolone and
immunosuppressive agent were most effective in these patients with
membranous nephropathy.
Prednisolone alone was the most effective on minimal change NS in the elderly. In the course of
therapy, side effects such as
pneumonia,
sepsis due to
fungus infections, such as aspergillus and candida, and
infection, such as cytomegalovirus and
herpes zoster, were more frequently observed, especially in the cases of MPGN, DPGN with moderate to severe mesangial proliferation, with a decline in renal function (Ccr < 50 L/day) and secondary NS. In secondary NS, the prognosis of
amyloidosis was very poor and the findings pointed to a relationship between
malignancy and
nephrotic syndrome.