CKD Progression to ESKD in Women

Despite the passage of nearly three decades since it was first suggested that sex may influence the course of CKD, the role that sex plays in promoting renal disease progression remains controversial. Arguably, large observational studies have established that women show less rapid progression of CKD than men, however, it remains to be established to what extent biologic versus cultural, lifestyle and socio-economic factors contribute to sexual dimorphism in renal disease progression. Complex interactions exist between biologic and non-biologic factors, making it difficult to elucidate the precise role that each play in mediating the effects of sex on renal disease progression. Despite these caveats, the authors believe that available data support the conclusion that sexual dimorphism in renal disease progression is primarily attributable to direct actions of sex hormones on cellular processes that influence renal injury and repair.