ArticleArthritis & rheumatology (Hoboken, N.J.)2018
Sex Differences in Health Care Utilization, End-Stage Renal Disease, and Mortality Among Medicaid Beneficiaries With Incident Lupus Nephritis.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Multiplicative Impact of Adverse Social Determinants of Health on Outcomes in Lupus Nephritis: A Meta-analysis and Systematic Review.Arthritis care & research · 2024Pooled it
- Sex hormones affect the pathogenesis and clinical characteristics of systemic lupus erythematosus.Frontiers in medicine · 2022Pooled it
- A Pooled Analysis of Sex Differences in Lupus Nephritis.Kidney international reports · 2026Article
- Understanding the Evidence Gaps in the Epidemiology and Burden of Lupus Nephritis and Membranous Nephropathy: A Targeted Literature Review.Journal of health economics and outcomes research · 2026Review
- Effect of race and sex on lupus diagnosis in primary care: A randomized factorial survey study.PloS one · 2026Article
- Global and China trends in glomerulonephritis-induced chronic kidney disease: health inequities, risk factors and projections to 2050.Renal failure · 2025Article
- Lupus nephritis.Nature reviews. Disease primers · 2025Review
- Increased prevalence, ER visits, and hospitalizations in medicare systemic lupus erythematosus patients living in socially vulnerable counties: A cross-sectional study.The American journal of the medical sciences · 2025Article
- Sex- and gender-related differences in systemic lupus erythematosus: a scoping review.Rheumatology international · 2025Article
- Sex disparity in non-communicable disease burden in Iran from 1990 to 2021 based on the global burden of disease study.Scientific reports · 2025Article
- Therapeutic Hydroxychloroquine Blood Levels Are Associated With Fewer Hospitalizations and Possible Reduction of Health Disparities in Lupus.Arthritis care & research · 2024Article
- Sex difference in human diseases: mechanistic insights and clinical implications.Signal transduction and targeted therapy · 2024Review
- International cohort of 382 children with lupus nephritis - presentation, treatment and outcome at 24 months.Pediatric nephrology (Berlin, Germany) · 2023Article
- Worse cardiovascular and renal outcome in male SLE patients.Scientific reports · 2023Article
- Disparities in Lupus and the Role of Social Determinants of Health: Current State of Knowledge and Directions for Future Research.ACR open rheumatology · 2023Review
- Chronic kidney disease is more prevalent among women but more men than women are under nephrological care : Analysis from six outpatient clinics in Austria 2019.Wiener klinische Wochenschrift · 2023Article
- Survival analysis of mortality and development of lupus nephritis in patients with systemic lupus erythematosus up to 40 years of follow-up.Rheumatology (Oxford, England) · 2022Article
- Predictors of Initial Hydroxychloroquine Receipt Among Medicaid Beneficiaries With Incident Systemic Lupus Erythematosus.Arthritis care & research · 2022Article
- The Economic Burden of Lupus Nephritis: A Systematic Literature Review.Rheumatology and therapy · 2022Review
- Increased Mortality Trends in Patients With Chronic Non-communicable Diseases and Comorbid Hypertension in the United States, 2000-2019.Frontiers in public health · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveWhile systemic lupus erythematosus and lupus nephritis (LN) disproportionately affect females, previous studies suggest that males may experience poorer outcomes. We undertook this study to investigate sex differences in health care utilization, end-stage renal disease (ESRD), and mortality among patients with LN receiving Medicaid, public insurance for low-income individuals.
methodsWithin the Medicaid Analytic eXtract (MAX) from 29 states (from 2000 to 2010), we used billing claims to identify individuals ages 5-65 years with incident LN (positive predictive value 80%). MAX data were linked to the US Renal Data System to determine ESRD and to Social Security Death Index files to determine death. We estimated adjusted incidence rate ratios (IRRs) by sex for health care utilization using Poisson regression, and we used multivariable proportional hazards models to compare risks of ESRD and death by sex.
resultsOf 2,750 patients with incident LN, 283 (10%) were male. The mean ± SD follow-up period for both sexes was 3.1 ± 2.3 years. The mean ± SD age was 29.6 ± 13.9 years among females and 24.7 ± 14.1 years among males (P < 0.01). Males had fewer outpatient visits (IRR 0.88 [95% confidence interval (95% CI) 0.80-0.97]) and fewer emergency department visits (IRR 0.75 [95% CI 0.63-0.90]). The 5-year cumulative incidence of ESRD was 22.3% in males and 21.2% in females. The 5-year cumulative incidence of death was 9.4% in males and 9.8% in females. Comparing males to females, there were no sex differences in ESRD (subdistribution hazard ratio [HR] 1.05 [95% CI 0.76-1.45]) or death (HR 0.81 [95% CI 0.47-1.35]).
conclusionIn this cohort of patients with incident LN, ESRD and mortality were extremely high overall but were not increased among males compared to females. In this vulnerable population, biologic and health care utilization differences by sex may not significantly affect outcomes.
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