Clinicopathological characteristics of lupus nephritis in Thai males

Abstract

Introduction: Lupus nephritis (LN) is a renal manifestation of systemic lupus erythematosus (SLE), an autoimmune disease more common in females. Clinicopathological manifestations and outcomes of LN in males are uncertain. Objectives: To assess and compare clinicopathological manifestations and outcomes of males and females with LN. Patients and Methods: Patients with LN were identified from database (male 94, female 344). Clinical manifestations, laboratory data, renal histopathology and outcome were retrieved and compared. Results: Compared to females, males were more likely to present with rapidly progressive glomerulonephritis (RPGN) (21.3% versus 11.6%, P = 0.026) and low-serum complement (76.6% versus 63.7%, P = 0.019). While asymptomatic hematuria and/or proteinuria was the second most common clinical manifestation in females (40%), no males presented with this manifestation. Although LN class IV was most common in both groups, males were more likely to have LN class IV with most severe form of renal manifestation than females (50% versus 38.7%, P = 0.048). Males showed tendency for poorer renal survival, but without statistical significance. Conclusion: Males with LN had more severe clinicopathological manifestations than females. Clinicians should be aware of SLE with LN in males in order to make timely diagnosis and treatment.

Candidate MicroRNA Biomarkers in Lupus Nephritis: A Meta-analysis of Profiling Studies in Kidney, Blood and Urine Samples

“…Such inconsistency might be due to variations in the study designs, the expression platforms, the population, the sample preparation methods, genetic, environmental, and clinicopathological conditions. In addition, gender and ethnic differences can be other factors that cause heterogeneous patterns in miRNA expression pro les (18,19). Carrying out a meta-analysis on pooled raw miRNA expression pro les is a scienti cally validated approach to overcome this challenge.…”

Evaluating Sex Differences in the Characteristics and Outcomes of Lupus Nephritis: A Systematic Review and Meta-Analysis

“…Activity and chronicity indices were reported in seven studies [ 24 , 28 , 29 , 36 , 38 , 39 , 44 ]. Men had numerically greater activity (MD 1.11, 95% CI: −0.07–2.29, I 2 = 96.69%, p < 0.001) and chronicity index scores (MD 0.42, 95% CI: −0.04–0.89, I 2 = 93.81%, p < 0.001) by small margins with substantial heterogeneity in both results (online suppl.…”

“…Regarding serologies, five studies compared the proportion of participants with low complement levels between the sexes [ 24 , 29 , 36 , 39 , 42 ]. Men were statistically significantly more likely to have hypocomplementemia (OR 1.68, 95% CI: 1.26–2.24, I 2 = 0%, p = 0.443) (online suppl.…”

“…Eleven studies compared kidney outcomes [ 24 , 27 – 29 , 31 , 36 , 37 , 39 , 43 , 44 , 46 ]. Mean follow-up ranged from 1.4 to 12.2 years.…”

“…Although the Cr was statistically significantly higher in men, the absolute difference between men and women (MD = 0.39 mg/dL) could be attributable to the expected physiological difference between sexes and may not necessarily reflect greater disease severity [ 55 ]. Assessment for a difference in estimated GFR between the sexes was not possible as this was reported by only a single study [ 39 ]. Our pooled analysis also demonstrated statistically significantly higher odds of worse kidney outcomes in men with LN (OR 2.20, 95% CI: 1.59–3.06).…”