Walsh_2021_Cohort.pdf (1.09 MB)
A cohort study to investigate sex‑specific differences in ANCA‑associated glomerulonephritis outcomes
journal contribution
posted on 2021-07-01, 07:41 authored by Jennifer Scott, Carolina Canepa, Antonia Buettner, Louise Ryan, Bróna Moloney, Sarah Cormican, Cathal Dominic Walsh, Arthur White, Alan D. Salama, Mark A. LittleData 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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National Research Foundation
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Japan Society for the Promotion of Science
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Publication
Scientific Reports;11, 13080Publisher
NatureNote
peer-reviewedOther Funding information
HRB, Wellcome Trust, Irish Nephrology Society, Horizon 2020, ERCLanguage
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