Comparison between males and females with lupus nephritis

Summary: In this study 17 male and 100 female cases with lupus nephritis were divided into four groups according to their clinical features at presentation. Each case was compared in order to identify sex-linked differences in their disease manifestations as well as underlying histopathological features and ultimate prognosis. the World Health Organization (WHO) histologic criteria were used for classification purposes. In all patients, age, chronicity index, duration of clinical activity of the disease before kidney biopsy and follow-up periods were statistically similar in the two groups of males and females. However, males had a significantly higher activity index in comparison to females at the time of initial kidney biopsy. In addition, diffuse proliferative histopathology was more common in males compared to females ( P = 0.002). Moreover, the renal and patient survival was significantly shorter in males as compared to female cases ( P = 0.0024, P = 0.0165, respectively). the proportions of males with severe lupus nephritis presenting with hypertension, reduced creatinine clearance, massive proteinuria and reduced levels of complement leading to end-stage renal disease was significantly higher compared to the females among the four clinical groups of the patients. In conclusion, our data indicates that lupus nephritis in males is a more progressive and severe disease in comparison to female cases. In addition its underlying histopathology is almost always diffuse proliferative lesions, leading to a poorer renal and patient survival in them.