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

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Show simple item record Scott, Jennifer Canepa, Carolina Buettner, Antonia Ryan, Louise Moloney, Bróna Cormican, Sarah Walsh, Cathal Dominic White, Arthur Salama, Alan D. Little, Mark A. 2021-07-01T07:41:23Z 2021-07-01T07:41:23Z 2021
dc.description peer-reviewed en_US
dc.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. en_US
dc.language.iso eng en_US
dc.publisher Nature en_US
dc.relation.ispartofseries Scientific Reports;11, 13080
dc.subject vasculitis glomerulonephritis en_US
dc.title A cohort study to investigate sex‑specific differences in ANCA‑associated glomerulonephritis outcomes en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1038/s41598-021-92629-7
dc.contributor.sponsor HRB en_US
dc.contributor.sponsor Wellcome Trust en_US
dc.contributor.sponsor Irish Nephrology Society en_US
dc.contributor.sponsor Horizon 2020 ERC en_US
dc.relation.projectid 203930/B/16/Z en_US
dc.relation.projectid 813545 en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US

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