Worse renal outcome of lupus nephritis in male patients: a case-control study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorRESENDE, A. L.
dc.contributor.authorTITAN, S. M.
dc.contributor.authorBARROS, R. T.
dc.contributor.authorWORONIK, V.
dc.date.accessioned2017-11-27T16:23:37Z
dc.date.available2017-11-27T16:23:37Z
dc.date.issued2011
dc.description.abstractBackground: Progression and long-term renal outcome of lupus nephritis (LN) in male patients is a controversial subject in the literature. The aim of this study was to evaluate the influence of male gender on the renal outcome of LN. Methods: All male (M) LN patients who fulfilled American College of Rheumatology lupus criteria and who were referred for a kidney biopsy from 1999 to 2009 were enrolled in the study. Subjects with end-stage renal disease at baseline, or follow-up time below 6 months, were excluded. Cases were randomly matched to female (F) patients according to the class of LN, baseline estimated glomerular filtration rate (eGFR, Modification of Diet in Renal Disease simplified formula) and follow-up time. Treatment was decided by the clinical staff based on usual literature protocols. The primary endpoint was doubling of serum creatinine and/or end-stage renal disease. The secondary endpoint was defined as a variation of glomerular filtration rate (GFR) per year (Delta GFR/y index), calculated as the difference between final and initial eGFR adjusted by follow-up time for each patient. Results: We included 93 patients (31 M : 62 F). At baseline, M and F patients were not statistically different regarding WHO LN class (II 9.7%, IV 71%, V 19.3%), eGFR (M 62.4 +/- 36.4 ml/min/1.73 m(2) versus F 59.9 +/- 32.7 ml/min/1.73 m(2)), follow-up time (M 44.2 +/- 27.3 months versus F 39.9 +/- 27.9 months), and 24-hour proteinuria (M 5.3 +/- 4.6 g/day versus F 5.2 +/- 3.0 g/day), as well as age, albumin, C3, antinuclear antibody, anti-DNA antibody and haematuria. There was no difference in the primary outcome (M 19% versus F 13%, log-rank p = 0.62). However, male gender was significantly associated with a worse renal function progression, as measured by Delta GFR/y index (beta coefficient for male gender -12.4, 95% confidence interval -22.8 to -2.1, p = 0.02). The multivariate linear regression model showed that male gender remained statistically associated with a worse renal outcome even after adjustment for eGFR, proteinuria, albumin and C3 complement at baseline. Conclusion: In our study, male gender presented a worse evolution of LN (measured by an under GFR recovering) when compared with female patients with similar baseline features and treatment. Factors that influence the progression of LN in men and sex-specific treatment protocols should be further addressed in new studies. Lupus (2011) 20, 561-567.
dc.description.indexMEDLINE
dc.identifier.citationLUPUS, v.20, n.6, p.561-567, 2011
dc.identifier.doi10.1177/0961203310392422
dc.identifier.issn0961-2033
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/22651
dc.language.isoeng
dc.publisherSAGE PUBLICATIONS LTD
dc.relation.ispartofLupus
dc.rightsrestrictedAccess
dc.rights.holderCopyright SAGE PUBLICATIONS LTD
dc.subjectcase-control study
dc.subjectlupus nephritis
dc.subjectmale gender
dc.subjectworse evolution
dc.subject.othersex-hormones
dc.subject.othergender-differences
dc.subject.otherrevised criteria
dc.subject.othermurine lupus
dc.subject.othererythematosus
dc.subject.otherdisease
dc.subject.otherimpact
dc.subject.otherglomerulonephritis
dc.subject.otherclassification
dc.subject.othermen
dc.subject.wosRheumatology
dc.titleWorse renal outcome of lupus nephritis in male patients: a case-control study
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus33
hcfmusp.contributor.author-fmusphcALINE LAZARA RESENDE
hcfmusp.contributor.author-fmusphcSILVIA MARIA DE OLIVEIRA TITAN
hcfmusp.contributor.author-fmusphcRUI TOLEDO BARROS
hcfmusp.contributor.author-fmusphcVIKTORIA WORONIK
hcfmusp.description.beginpage561
hcfmusp.description.endpage567
hcfmusp.description.issue6
hcfmusp.description.volume20
hcfmusp.origemWOS
hcfmusp.origem.pubmed21415256
hcfmusp.origem.scopus2-s2.0-79956066829
hcfmusp.origem.wosWOS:000290376600003
hcfmusp.publisher.cityLONDON
hcfmusp.publisher.countryENGLAND
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