A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes

A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes

Abstract 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. P...

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Autores principales: Jennifer Scott, Carolina Canepa, Antonia Buettner, Louise Ryan, Bróna Moloney, Sarah Cormican, Cathal Walsh, Arthur White, Alan D. Salama, Mark A. Little
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/128b8a48ac87401bb9d5b2877cdb9a1b
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spelling oai:doaj.org-article:128b8a48ac87401bb9d5b2877cdb9a1b2021-12-02T17:12:17ZA cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes10.1038/s41598-021-92629-72045-2322https://doaj.org/article/128b8a48ac87401bb9d5b2877cdb9a1b2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92629-7https://doaj.org/toc/2045-2322Abstract 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.Jennifer ScottCarolina CanepaAntonia BuettnerLouise RyanBróna MoloneySarah CormicanCathal WalshArthur WhiteAlan D. SalamaMark A. LittleNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Jennifer Scott
Carolina Canepa
Antonia Buettner
Louise Ryan
Bróna Moloney
Sarah Cormican
Cathal Walsh
Arthur White
Alan D. Salama
Mark A. Little
A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes
description Abstract 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.
format article
author Jennifer Scott
Carolina Canepa
Antonia Buettner
Louise Ryan
Bróna Moloney
Sarah Cormican
Cathal Walsh
Arthur White
Alan D. Salama
Mark A. Little
author_facet Jennifer Scott
Carolina Canepa
Antonia Buettner
Louise Ryan
Bróna Moloney
Sarah Cormican
Cathal Walsh
Arthur White
Alan D. Salama
Mark A. Little
author_sort Jennifer Scott
title A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes
title_short A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes
title_full A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes
title_fullStr A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes
title_full_unstemmed A cohort study to investigate sex-specific differences in ANCA-associated glomerulonephritis outcomes
title_sort cohort study to investigate sex-specific differences in anca-associated glomerulonephritis outcomes
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/128b8a48ac87401bb9d5b2877cdb9a1b
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