Abstract
Chronic kidney disease affects approximately 10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women's health and specifically women’s kidney health on the community and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly. Girls and women, who make up approximately 50% of the world's population, are important contributors to society and their families. Gender differences continue to exist around the world in access to education, medical care, and participation in clinical studies. Pregnancy is a unique state for women, offering an opportunity for diagnosis of kidney disease, but also a state in which acute and chronic kidney diseases may manifest, and which may impact future generations with respect to kidney health. Various autoimmune and other conditions are more likely to impact women, with profound consequences for child bearing and the fetus. Women have different complications on dialysis than men, and are more likely to be donors than recipients of kidney transplants. In this editorial, we focus on what we know and do not know about women, kidney health, and kidney disease, and what we might learn in the future to improve outcomes worldwide.
Highlights
Chronic kidney disease (CKD) affects approximately 10% of the world’s adult population: it is within the top 20 causes of death worldwide [1], and its impact on patients and their families can be devastating
In the context of specific therapies for the treatment or delay of CKD progression, do we know if there are gender differences in therapeutic responses to angiotensin-converting-enzyme inhibitor/angiotensin II receptor blockers? Should we look at dose adjustments by gender? If vascular and immune biology is affected by gender hormones as described earlier, what is the impact of various therapies by level or ratio of gender hormones? In low-middle income countries, how does changing economic and social cultures affect women’s health, and what is the nutritional impact on CKD of increasing predominance of obesity, diabetes, and hypertension?
Advocating for improved access to care for women is critical to maintain the health of families, communities, and populations
Summary
Chronic kidney disease (CKD) affects approximately 10% of the world’s adult population: it is within the top 20 causes of death worldwide [1], and its impact on patients and their families can be devastating. Girls and women, who make up approximately 50% of the world’s population, are important contributors to society and their families. In various locations around the world, access to education and medical care is not equitable amongst men and women; women remain underrepresented in many clinical research studies, limiting the evidence base on which recommendations are made to ensure the best outcomes (Figure 1). In this editorial, we focus on what we know and do not know about women’s kidney health and kidney disease, and what we might learn in the future to improve outcomes for all
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