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

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dc.contributor.author Scott, Jennifer
dc.contributor.author Canepa, Carolina
dc.contributor.author Buettner, Antonia
dc.contributor.author Ryan, Louise
dc.contributor.author Moloney, Bróna
dc.contributor.author Cormican, Sarah
dc.contributor.author Walsh, Cathal Dominic
dc.contributor.author White, Arthur
dc.contributor.author Salama, Alan D.
dc.contributor.author Little, Mark A.
dc.date.accessioned 2021-07-01T07:41:23Z
dc.date.available 2021-07-01T07:41:23Z
dc.date.issued 2021
dc.identifier.uri http://hdl.handle.net/10344/10293
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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