Sexual dimorphism plays an important role in the pathogenesis and progression of chronic kidney disease (CKD). Men with CKD often exhibit faster kidney function decline, leading to higher rates of kidney failure and mortality compared to women. Studies suggest that sex hormones may influence this apparent dimorphism, although the mechanisms underlying these influences remain poorly understood. In this review, we first summarize recent findings on sex differences in the prevalence and progression of CKD. Subsequently, we will focus on (1) the role of sex hormones in these sex differences, (2) kidney structural and hemodynamic differences between men and women, (3) the influence of sex hormones on pathophysiological processes leading to kidney disease, including glomerular hyperfiltration and key pathways involved in kidney inflammation and fibrosis, and finally, focus on the consequences of the underrepresentation of women in clinical trials. Understanding these sex differences is critical for advancing precision medicine and improving outcomes for both men and women with CKD.

中文翻译：

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揭示肾脏健康和慢性肾病的性别差异：性激素影响综述。


性二态性在慢性肾脏病 （CKD） 的发病机制和进展中起重要作用。患有 CKD 的男性通常表现出更快的肾功能下降，与女性相比，导致肾衰竭和死亡率更高。研究表明，性激素可能会影响这种明显的二态性，尽管这些影响背后的机制仍然知之甚少。在本综述中，我们首先总结了 CKD 患病率和进展的性别差异的最新发现。随后，我们将关注 （1） 性激素在这些性别差异中的作用，（2） 男性和女性之间的肾脏结构和血流动力学差异，（3） 性激素对导致肾脏疾病的病理生理过程的影响，包括肾小球高滤过和参与肾脏炎症和纤维化的关键途径，最后，关注女性在临床试验中代表性不足的后果。了解这些性别差异对于推进精准医疗和改善 CKD 男性和女性患者的预后至关重要。