Lupus nephritis in males; updates to current knowledge

Abstract

Studies have demonstrated that male systemic lupus erythematosus (SLE) patients present with atypical manifestations, serious kidney involvement and worse prognosis. This article summarizes the findings obtained from the literature review of 16 studies to obtain an understanding of the gender correlation with SLE and lupus nephritis. We compared the influence of gender on various factors of SLE like incidence of lupus nephritis, age at manifestation of SLE, time between SLE manifestation and lupus nephritis diagnosis, frequency of dialysis, mortality risk and biopsy findings. Studies included in our review composed of remote published work, case-control studies, case reports and cross-sectional studies. Of 16 studies, 14 were conducted exclusively on lupus nephritis in SLE with comparison of gender correlation and remaining 2 studied SLE generally without any gender comparison. Six studies pointed to an increase in incidence of lupus nephritis in males, 9 studies demonstrated no disparity in gender, and one study showed contradicting results. In addition, 4 studies pointed that males had a more severe renal outcome as revealed by laboratory tests. Interestingly the age at which SLE manifests was the same in both genders according to 2 studies. Moreover, the frequency of dialysis and remission were similar between both genders. There is no consensus if these atypical manifestations are more common in males. Although some studies do show a significant increase in lupus nephritis among male SLE patients, others showed no difference or contradicting results. Hence, we suggest further studies comparing the disease manifestations.

Keywords

• Systemic lupus erythematosus
• Lupus nephritis
• Males
• Renal outcome
• End stage renal disease