Abstract
BackgroundThe prognostic effect of gender on immunoglobulin A nephropathy (IgAN) is not clear. We explored gender-related differences in clinicopathological features and renal outcomes in IgAN.MethodsThis was a single-centre retrospective study. Patients were divided into two groups according to gender. The clinicopathological features at biopsy and renal outcomes during the follow-up were collected and analysed. Renal outcomes were defined as the doubling of baseline serum creatinine and end-stage renal disease (ESRD) (estimated glomerular filtration rate < 15 mL/min/1.73 m2, dialysis, or renal transplantation). The prognostic effects of gender were evaluated by Cox regression models.ResultsA total of 988 eligible IgAN patients were enrolled, and the ratio of males to females was 1:1.4. Compared with female patients, male patients had worse renal function, greater proteinuria, a higher prevalence of hypertension, hypertriglyceridaemia and hyperuricaemia, and more severe segmental sclerosis and tubular atrophy/interstitial fibrosis. However, haematuria occurred more frequently in female patients. During a median follow-up time of 48.6 (34.7, 62.7) months, no differences in renal survival rates were noted between the male and female groups. Multivariable Cox regression analyses revealed that gender was not a significant risk factor for renal outcomes after frequency matching of baseline eGFR and serum uric acid (SUA) levels. In addition, male and female patients shared similar risk factors, including a low eGFR and increased proteinuria and segmental sclerosis. In males, however, an elevated proportion of global glomerulosclerosis was also a poor prognostic factor for renal survival.ConclusionsMale IgAN patients presented with worse clinicopathologic features than female patients, but no significant differences were observed in long-term renal survival between male and female patients by eGFR- and SUA level-matching.
Highlights
The prognostic effect of gender on immunoglobulin A nephropathy (IgAN) is not clear
Clinicopathological features of IgAN patients A total of 988 IgAN patients were analysed in this study
We found that male IgAN patients presented with worse clinicopathological features than female patients
Summary
The prognostic effect of gender on immunoglobulin A nephropathy (IgAN) is not clear. We explored gender-related differences in clinicopathological features and renal outcomes in IgAN. Immunoglobulin A nephropathy (IgAN) is a common glomerulonephritic disease that is one of the major causes of end-stage renal disease (ESRD) [1]. The prevalence of IgAN in male and female patients differs geographically. The ratios of male to female patients range. Few studies have described the associations between gender and renal outcomes [8, 12]. To better understand these associations in IgAN patients, we conducted a retrospective study of a large number of Chinese patients with biopsy-diagnosed primary IgAN
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