Gender-related differences in IgA nephropathy; an eleven-year experience according to revised Oxford classification

Abstract

Introduction: IgA nephropathy (IgAN) is a common glomerular disease characterized by dominant or co-dominant granular IgA deposits in the glomerular mesangial areas. Objectives: This study aimed to determine the possible gender-related differences in IgAN at a single center in Iran. Patients and Methods: All renal biopsy-proven cases of IgAN during the last 11 years (2009-2020) were studied. All kidney biopsies had two samples for immunofluorescence and light microscopy. Renal biopsies were reviewed using the recently revised Oxford classification of IgAN. In addition to Oxford-MEST morphologic variables, other data consisting of age, gender, serum creatinine and level of proteinuria within 24 hours at the time of biopsy were collected. The data were analyzed in SPSS version 21.0. Results: This study included 246 biopsy-proven cases of IgAN patients with a mean age of 38.23±13.71 years and a male prevalence of 67.1% (n=161). The mean ± SD values of serum creatinine and 24-hour proteinuria were 1.47±1.06 mg/dL and 1753.63±1049.418 mg/d, respectively. Analysis regarding age, serum creatinine, the quantity of 24-hour proteinuria, the number of sclerotic glomeruli, and the percent of interstitial fibrosis showed only serum creatinine to be significantly higher in males than females (P=0.017). Moreover, 24-hour proteinuria was higher in males than females (P=0.047). Our study showed that males have more segmental sclerosis (P=0.023) and more significant IgM deposits than females (P=0.003). The mean scores of IgA, IgG, and C3 deposited immunological reactants were not substantially different between males and females (P>0.05). Conclusion: Our study showed that serum creatinine and proteinuria were significantly higher in males. Males also had higher segmental sclerosis on biopsies. Larger-scale research is needed to confirm our results.