Rune Bjørneklett1,2, Vilde Solbakken3, Leif Bostad4, Anne-Siri Fismen5. 1. Department of Clinical Medicine, University of Bergen, Jonas Lies vei 91b, 5021, Bergen, Norway. rune.bjoerneklett@helse-bergen.no. 2. Emergency Care Clinic, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway. rune.bjoerneklett@helse-bergen.no. 3. Department of Clinical Medicine, University of Bergen, Jonas Lies vei 91b, 5021, Bergen, Norway. 4. Department of Pathology, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway. 5. Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway.
Abstract
PURPOSE: Sex-specific differences in the risk of end-stage renal disease (ESRD) in patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) stratified by histological classification have not been previously investigated. METHODS: Patients with biopsy-verified pauci-immune necrotizing GN and positive ANCA serology in the Norwegian Kidney Biopsy Registry between 1991 and 2012 were included. Patients with ESRD during follow-up were identified from the Norwegian Renal Registry. ESRD-free survival stratified by histological classifications was investigated. RESULTS: We analyzed 358 patients, of whom 87 progressed to ESRD during follow-up. Overall ESRD-free survival at 1 and 5 years in the entire cohort was 81 and 71% in males versus 90 and 80% in females, respectively; 94 and 84% in males versus 98 and 98% in females with focal histology, respectively; 85 and 76% in males versus 89 and 77% in females with mixed histology, respectively; 72 and 58% in males versus 90 and 78% in females with crescentic histology, respectively; and 52 and 46% in males versus 60 and 38% in females with sclerotic histology, respectively. Males had an increased risk of ESRD (adjusted hazard ratio, 2.44 [1.56-3.82]; p < 0.001). CONCLUSION: Male sex is associated with increased risk of ESRD across all histological classes of ANCA-GN.
PURPOSE: Sex-specific differences in the risk of end-stage renal disease (ESRD) in patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) stratified by histological classification have not been previously investigated. METHODS:Patients with biopsy-verified pauci-immune necrotizing GN and positive ANCA serology in the Norwegian Kidney Biopsy Registry between 1991 and 2012 were included. Patients with ESRD during follow-up were identified from the Norwegian Renal Registry. ESRD-free survival stratified by histological classifications was investigated. RESULTS: We analyzed 358 patients, of whom 87 progressed to ESRD during follow-up. Overall ESRD-free survival at 1 and 5 years in the entire cohort was 81 and 71% in males versus 90 and 80% in females, respectively; 94 and 84% in males versus 98 and 98% in females with focal histology, respectively; 85 and 76% in males versus 89 and 77% in females with mixed histology, respectively; 72 and 58% in males versus 90 and 78% in females with crescentic histology, respectively; and 52 and 46% in males versus 60 and 38% in females with sclerotic histology, respectively. Males had an increased risk of ESRD (adjusted hazard ratio, 2.44 [1.56-3.82]; p < 0.001). CONCLUSION: Male sex is associated with increased risk of ESRD across all histological classes of ANCA-GN.
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