Minimal change glomerulonephritis in a 90-year-old patient: what is the ideal approach?

We report the case of a 90-year-old lady who presented with full-blown nephrotic syndrome. Percutaneous renal biopsy allowed us to confirm the diagnosis of minimal change glomerulopathy; she entered a 2-year period of remission after a 6-month course of prednisone (starting dose 1.5 mg/kg). The patient sustained minor effects of both renal biopsy and corticotherapy. Percutaneous renal biopsy is justified in the very elderly because the risk of mortality and morbidity related to corticotherapy outweigh the risk related to percutaneous renal biopsy, providing high-risk patients are excluded, such as amyloidosis or abnormal coagulation or uncontrolled arterial hypertension.