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Related Concept Videos

Hormonal Regulation01:33

Hormonal Regulation

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The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
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Introduction to Urinary System01:13

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The urinary system consists of two kidneys, two ureters, the urinary bladder, and the urethra.
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Endocrinal or hormonal intervention in the cardiovascular system is predominantly exerted by the catecholamines - epinephrine and norepinephrine, as well as a slew of hormones that interact with renal function to modulate blood volume.
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The kidneys are two large bean-shaped organs located in the upper abdomen. They filter the blood several times a day to remove toxins and rebalance water and electrolytes of the circulatory system via the renal veins. The kidneys receive blood directly from the heart via the renal arteries. These arteries enter the kidney at the hilum, the concave surface of the bean, where they branch and divide into smaller vessels and capillaries.
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Physiology of Urine Formation01:24

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Urine formation is an essential function of the human body. It plays a critical role in maintaining homeostasis by regulating the volume and composition of body fluids. The kidneys, the primary organs involved in this process, filter blood to remove waste products and excess substances, ultimately producing urine.
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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Related Experiment Video

Updated: May 15, 2025

Estrogen-Like Effect of Bazi Bushen Capsule in Ovariectomized Rats
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Unveiling mechanisms underlying kidney function changes during sex hormone therapy.

Sarah A van Eeghen1,2,3, Laura Pyle4,5, Phoom Narongkiatikhun4,6

  • 1Center of Expertise on Gender Dysphoria, Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, Netherlands.

The Journal of Clinical Investigation
|April 7, 2025
PubMed
Summary

Sex hormones significantly impact kidney health. Estradiol demonstrates protective effects on kidney function and tubular health, while testosterone shows opposing effects, highlighting potential for sex-specific precision medicine in chronic kidney disease.

Keywords:
Chronic kidney diseaseEndocrinologyNephrologySex hormones

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Area of Science:

  • Nephrology
  • Endocrinology
  • Proteomics

Background:

  • Men with chronic kidney disease (CKD) exhibit accelerated kidney function decline compared to women.
  • Sex hormones are implicated, with feminizing therapy increasing and masculinizing therapy decreasing estimated glomerular filtration rate (eGFR).
  • The specific effects of sex hormones on measured GFR (mGFR), kidney perfusion, tubular function, and molecular mechanisms remain largely uncharacterized.

Purpose of the Study:

  • To investigate the impact of feminizing (estradiol and antiandrogens) and masculinizing (testosterone) hormone therapy on kidney physiology in individuals with CKD.
  • To explore the effects on measured GFR (mGFR), kidney perfusion, tubular injury biomarkers, and plasma proteomic profiles.
  • To elucidate the molecular mechanisms underlying sex hormone influence on kidney function and sexual dimorphism in CKD.

Main Methods:

  • Prospective observational study involving individuals initiating feminizing (n=23) or masculinizing (n=21) therapy.
  • Assessment of mGFR (iohexol clearance), kidney perfusion (para-aminohippuric acid clearance), and urinary tubular injury biomarkers at baseline and 3 months.
  • Plasma proteomics analysis to identify differentially expressed proteins and their association with hormone levels and kidney function.

Main Results:

  • Feminizing therapy increased mGFR (+3.6%) and kidney perfusion (+9.1%) without altering glomerular pressure. Significant reductions in tubular injury biomarkers (e.g., YKL-40, EGF, MCP-1) were observed.
  • Masculinizing therapy showed no significant changes in mGFR or perfusion, but increased urine YKL-40 (+134%) and plasma TNFR-1 (+8%).
  • Proteomic analysis revealed distinct protein expression patterns: 49 proteins with feminizing therapy and 356 with masculinizing therapy. Kidney-protective proteins correlated positively with estradiol and negatively with testosterone.

Conclusions:

  • Sex hormones exert significant influence on kidney physiology, with estradiol demonstrating protective effects on glomerular and tubular function.
  • Testosterone appears to have predominantly opposing effects on kidney health.
  • These findings underscore the role of sex hormones in the sexual dimorphism of kidney function and suggest potential for sex-specific precision medicine strategies in managing CKD.