Sex-specific course of renal involvement in vasculitides

Background: Sex-related issues in the pathophysiology, diagnostics and treatment are increasingly coming into scientific interest also in the field of nephrology. In the following sex-specific differences in renal involvement of vasculitis are evaluated. Material and method: A literature search was carried out in PubMed and the current knowledge on sex-specific differences in selected clinically meaningful vasculitides are summarized. Results: Men frequently show worse renal outcome data than women. In this context, concrete sex-specific histopathological and molecular biological correlations, which promise sex-specific diagnostic and therapeutic approaches, are so far lacking; however, evaluation of renal biopsies in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis shows differences in the degree of inflammation, with respect to interstitial inflammation and peritubular capillaritis. Accordingly, significantly less interstitial inflammation and peritubular capillaritis were detected in female patients. Conclusion: To date no sex-specific therapeutic approaches for vasculitis with renal involvement can be derived from the available data. For this purpose, a scientific focus should be set on the sex-specific histopathological and molecular biological characteristics in order to have a better understanding of the identified poorer renal and global survival of men compared to women. Subsequently, different treatment approaches should be urgently investigated and discussed.