Lupus nephritis (LN) is a major complication of
systemic lupus erythematosus. Early intervention in
lupus nephritis improves prognosis. There is an association between
hyperuricemia and
lupus nephritis; nevertheless, the sex-specific role of
uric acid in
lupus nephritis remains unclear. We retrospectively analyzed 578 patients diagnosed with LN by renal biopsy. We determine the relationship of serum
uric acid to progression of LN using Kaplan-Meier survival analyses and Cox proportional hazards models. The primary end point was LN progression defined as the initiation of dialysis or
kidney transplantation. Men had higher mean serum
uric acid levels than did women. Every 1 mg/dL increase in baseline
uric acid level increased the risk of LN progression by 15.1%. The serum
uric acid level was an independent risk factor for LN progression in women (hazard ratio [HR], 1.158; confidence interval [CI], 1.018-1.317; p = 0.028) but not in men (HR, 1.499; CI, 0.964-2.331; p = 0.072). Sensitivity analysis involving serum
uric acid terciles generated consistent and robust results. Serum
uric acid level was an independent risk factor for LN progression in women but not in men.