Journal
SCIENTIFIC REPORTS
Volume 11, Issue 1, Pages -Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41598-021-92629-7
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Funding
- Wellcome Trust [203930/B/16/Z]
- Health Research Board [203930/B/16/Z]
- Health Service Executive, National Doctors Training and Planning
- Health and Social Care, Research and Development Division, Northern Ireland
- Health Research Board/Irish Nephrology Society [MRCG-2016-12]
- European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant [813545]
- Health Research Board (HRB) [MRCG-2016-12] Funding Source: Health Research Board (HRB)
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Sex does not have a strong impact on renal outcomes in patients with ANCA-associated vasculitis glomerulonephritis (ANCA-GN), and treatment intensity does not vary by sex.
Data surrounding sex-specific differences in ANCA-associated vasculitis glomerulonephritis (ANCA-GN) outcomes is sparse. We hypothesised that the previously observed increased risk of end-stage kidney disease (ESKD) in males is driven by sex-specific variation in immunosuppression dosing. Patients were recruited to the Irish Rare Kidney Disease Registry or followed by the Royal Free Hospital vasculitis team (2012-2020). Inclusion criteria: prior diagnosis of ANCA-GN (biopsy proven pauci-immune glomerulonephritis) and positive serology for anti-MPO or -PR3 antibodies. Renal and patient survival, stratified by sex and Berden histological class, was analysed. The cumulative- and starting dose/kilogram of induction agents and prednisolone, respectively, was compared between sexes. 332 patients were included. Median follow-up was time 40.2 months (IQR 17.3-69.2). 73 (22%) reached ESKD and 47 (14.2%) died. Overall 1- and 5-year renal survival was 82.2% and 76.7% in males and 87.1% and 82.0% in females, respectively (p 0.13). The hazard ratio for ESKD in males versus females, after adjustment for age, ANCA serology, baseline creatinine and histological class was 1.07 (95% CI 0.59-1.93). There was no difference between sexes in the dose/kilogram of any induction agent. We did not observe a strong impact of sex on renal outcome in ANCA-GN. Treatment intensity does not vary by sex.
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