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Sex Differences in Kidney Health and Disease.
Brian J Harvey1,2, Diego Alvarez de la Rosa3
1Faculty of Medicine, Royal College of Surgeons in Ireland, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Nephron
|October 15, 2024
Summary
Sex hormones significantly impact kidney function and disease. Estrogen offers protection in females, while testosterone can impair kidney health, highlighting the need for sex-specific medical approaches.
Area of Science:
- Nephrology
- Endocrinology
- Sex Differences in Medicine
Background:
- Sex hormones, including estrogen, progesterone, and testosterone, play a crucial role in kidney physiology and disease.
- Biological actions of sex hormones underpin observed sex differences in kidney health and disease.
- This review focuses on hormonal and molecular signaling pathways involved in these sex differences.
Purpose of the Study:
- To provide an up-to-date discussion of hormonal and molecular signaling pathways implicated in sex differences in kidney health and disease.
- To highlight the protective effects of estrogen and progesterone on renal function and the detrimental effects of testosterone.
- To emphasize the importance of sex-specific considerations in clinical practice and research.
Main Methods:
- Literature review of current research on sex hormones and kidney function.
- Analysis of molecular and hormonal signaling pathways.
- Discussion of sex differences in various kidney diseases and renal cancer.
Main Results:
- Estrogen and progesterone demonstrate protective effects on renal blood flow, glomerular filtration rate, and ion/water transport.
- Estrogen is particularly important for reinforcing kidney function and protecting against kidney diseases in females.
- Estrogen promotes extracellular fluid volume homeostasis by stimulating sodium and water channel expression and transport.
- The female advantage in kidney health is linked to estrogenic effects and XX chromosome influences on immune responses.
- Women exhibit lower incidence, morbidity, and mortality in renal cancer compared to men.
Conclusions:
- Sex-specific hormonal influences are critical in maintaining kidney health and preventing disease.
- Estrogen plays a significant protective role in female kidney physiology and disease outcomes.
- Incorporating sex-specific approaches in clinical practice and research is essential to address biological sex disparities in kidney disease and renal cancer.
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