Clinicopathological study of male and female patients with lupus nephritis: a retrospective study

The aim of this study was to assess the impact of sex on long-term outcomes in patients with lupus nephritis (LN).

Data of patients were collected at a single tertiary hospital from June 2010 to June 2016. Clinicopathological features and treatment responses of LN patients with different genders were compared. The primary endpoint was serum creatinine level doubled, GFR < 15 mL/min, initiation of renal replacement treatment or death. The secondary endpoint was complete remission or partial remission.

In total, 101 male patients and 579 females were included. The follow-up time was 49.7 ± 15.2 months. In clinical data, photosensitivity and mouth ulcers were more common in the female patients, while males had more serositis and vasculitis. In laboratory data, males had higher values of blood pressure, hemoglobin, urine protein, serum creatinine and a lower level of serum albumin. Activity index and endocapillary hypercellularity scores in the male group were significantly increased. No sex disparity was identified across secondary endpoints in all cases, despite a lower ratio of CR in males. As for the long-term survival, no statistic difference between the two groups was observed. In a further multivariate Cox hazard analysis, male gender was not identified as an independent risk factor for poor outcomes.

Despite a greater disease activity and more severe organ damage in males with LN, we did not observe any significant gender disparity in long-term survival. Large multicenter collaborative efforts are necessary.