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Introduction: Glomerular diseases in the elderly population are a challenging clinical dilemma, and kidney biopsy is of paramount importance to clarify the morphological changes. The aim of this study was to evaluate the prevalence of major glomerulopathies that affect older adults. Methods: This retrospective study included 70 adults aged >65 years and was performed at four tertiary centres in Saudi Arabia between January 2001 and December 2017. Results: There were 74 native kidney biopsies, which accounted for 7.2% of all native renal biopsies that were performed in the 16-year period. Furthermore, 64% of the native biopsied patients were men. The most common clinical presentations were nephrotic syndrome (40%) and acute kidney injury (20%). In older adults with primary glomerular diseases, IgA nephropathy was the most frequent pathological type (36.4%), whereas diabetes mellitus was the most frequent etiology (37.5%) for secondary glomerular diseases. Women were more likely to develop diabetic nephropathy. Conclusion: The prevalence of IgA is progressively increasing and is currently the most frequent type of primary glomerular disease diagnosed in senior adult. Diabetes has become the leading cause of secondary glomerular disease. Renal biopsy is therefore of paramount importance because an accurate diagnosis will help clinicians establish the diagnosis and guide therapy for both younger and older adults.

Spectrum of Biopsy-Proven Kidney Diseases in Older Saudi Adults, 2001-2017