Clinical Edge

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Sex Differences in Healthcare Utilization in LN

Arthritis Rheumatol; ePub 2017 Nov 28; Feldman, et al

In an incident lupus nephritis (LN) cohort (n=2,750), end-stage renal disease (ESRD) and mortality were extremely high overall, but not increased among males compared to females, a recent study found. Therefore, in this vulnerable population, biologic and healthcare utilization differences by sex may not significantly affect outcomes. Within Medicaid Analytic eXtract (MAX) from 29 states (2000-2010), researchers used billing claims to identify individuals aged 5 to 65 years with incident LN. MAX data were linked to the US Renal Data System to determine ESRD, and to Social Security Death Index files to determine death. They found:

  • Of total patients with incident LN, 283 (10%) were male.
  • Mean follow-up was 3.1 (SD 2.3); mean age was 25 (SD 14) years among males; 30 (SD 14) among females.
  • Males had fewer outpatient and emergency department visits.
  • The 5-year cumulative incidence of ESRD was 22.3% in males, 21.2% in females, and of death, 9.4% in males, 9.8% in females.
  • There were no sex differences in ESRD or death.


Feldman CH, Broder A, Guan H, Yazdany J, Costenbader KH. Sex differences in healthcare utilization, end-stage renal disease and mortality among Medicaid beneficiaries with incident lupus nephritis. [Published online ahead of print November 28, 2017]. Arthritis Rheumatol. doi:10.1002/art.40392.

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