{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:52:22Z","timestamp":1792788742256,"version":"4.5.0"},"reference-count":68,"publisher":"Ovid Technologies (Wolters Kluwer Health)","funder":[{"name":"National Institute of Diabetes and Digestive and Kidney Diseases","award":["U24DK100845, U01DK100846, U01DK100876, U01DK100866, and U01DK100867"],"award-info":[{"award-number":["U24DK100845, U01DK100846, U01DK100876, U01DK100866, and U01DK100867"]}],"id":[{"id":"https:\/\/ror.org\/00adh9b73","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Nephcure Foundation","id":[{"id":"https:\/\/ror.org\/043bb8m89","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Elderly onset primary glomerular diseases are characterized by decreased GFR and a higher comorbidity burden compared with younger adult subgroups.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Histologic features of nephrosclerosis become more prevalent with advancing age.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Excess morbidity, mortality and, possibly, underlying biologic differences, shape outcomes in elderly onset primary glomerular diseases.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary glomerular diseases (PGDs) are not uncommon in elderly patients, where age-related histologic changes, frailty, and multimorbidity overlap with disease-specific drivers of damage. Evidence on the impact of older age at onset on PGD presentation and outcomes remains heterogeneous. This retrospective multicenter study assessed the impact of older age at diagnosis on the clinical\u2013histologic presentation, treatment, and outcome of PGDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults with biopsy-proven minimal change disease, FSGS, membranous nephropathy, and IgA nephropathy\/vasculitis with nephritis enrolled in Cure Glomerulonephropathy between 2014 and 2023 with available kidney function data were stratified by age at diagnosis into three age groups: young adults (18\u201339 years), middle-aged adults (40\u201364 years), and elderly patients (\u226565 years). Clinical\u2013histologic features and treatment patterns were compared across age groups, with a focus on elderly patients. Evaluated outcomes included all-cause mortality and a composite kidney outcome (&gt;40% eGFR decline or kidney failure). Cox regression and Fine\u2013Gray models were fitted to evaluate the impact of age on the composite kidney outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1562 adults, 211 were aged \u226565 years at diagnosis. Elderly patients exhibited a higher comorbidity burden and lower eGFR at enrollment (55 [34\u201375] versus 84 [50\u2013115] in young adults and 65 [43\u201391] ml\/min in middle-aged adults,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). In 704 biopsies with an available Cure Glomerulopathy Pathology Classification, nephrosclerosis features\u2014particularly arteriosclerosis\u2014increased with advancing age, whereas disease-specific features were similar across age groups. Elderly patients more often received conservative or steroid-sparing regimens. A 5-year excess mortality of 7%\u201314% compared with young adults was observed in the elderly patients. In adjusted models, older age was independently protective for the composite kidney outcome (subdistribution hazard ratios 0.65\u20130.79).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Aging adds comorbidity and histologic chronicity without altering PGDs phenotype; excess mortality and, possibly, underlying biologic differences shape outcomes in elderly onset PGDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000001163","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:01:23Z","timestamp":1786118483000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Primary Glomerular Diseases in the Elderly"],"prefix":"10.2215","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4375-4942","authenticated-orcid":false,"given":"Martina","family":"Tedesco","sequence":"first","affiliation":[{"name":"Division of Nephrology and Dialysis, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili of Brescia, Brescia, Italy"},{"name":"Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2759-4027","authenticated-orcid":false,"given":"Federica","family":"Mescia","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Dialysis, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili of Brescia, Brescia, Italy"},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9267-7956","authenticated-orcid":false,"given":"Becky Mingyao","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0712-2329","authenticated-orcid":false,"given":"Maddalena","family":"Maras\u00e0","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases \u201cAldo e Cele Dacc\u00f2\u201d, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7209-0687","authenticated-orcid":false,"given":"Shanthi S.","family":"Balani","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Coppock","sequence":"additional","affiliation":[{"name":"Department of Medicine, Renal Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7662-7497","authenticated-orcid":false,"given":"Vimal","family":"Derebail","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-764X","authenticated-orcid":false,"given":"Laura H.","family":"Mariani","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4258-1726","authenticated-orcid":false,"given":"Amy K.","family":"Mottl","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7381-7516","authenticated-orcid":false,"given":"Mariela","family":"Navarro-Torres","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New 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