The histomorphology of the senescent kidney - the clinical relevance of specimen and biopsy findings in the elderly native kidneys.

Purpose of review: Renal pathology is crucial in diagnosing the ageing kidney. Recent technological advances enabled high-resolution molecular investigations into the complex mechanisms of ageing and senescence.

Recent findings: The pathological analysis of large kidney tissue collections coupled with computer-assisted morphometry contributed to the establishment of age-related reference values for glomerular or vascular sclerosis, interstitial fibrosis, and tubular atrophy. Furthermore, new high-throughput proteomic and transcriptomic platforms have entered the field of pathology. When coupled with morphology information, these techniques facilitated the study of extracellular matrix modifications and the senescent immune system in the ageing kidney. Finally, iatrogenic complications are now frequent indications for diagnostic kidney biopsies in older patients, potentially accelerating kidney senescence.

Summary: Recent pathology literature supports identifying and prognosticating sclerosing processes in ageing kidneys.