THE IMPACT OF GENDER ON THE PROGRESSION OF CHRONIC RENAL-DISEASE

Observations in experimental animals and in humans have strewn that th e rate of progression of renal disease is influenced by gender. Deteri oration of renal function in patients with chronic renal disease is mo re rapid in men than in women, independent of differences in blood pre ssure or serum cholesterol levels. In addition to genetically determin ed differences between the sexes in renal structure and function, sex hormones may directly influence many of the processes implicated in th e pathogenesis of renal disease progression. Potential mechanisms incl ude receptor-mediated effects of sex hormones on glomerular hemodynami cs and mesangial cell proliferation and matrix accumulation as well as effects on the synthesis and release of cytokines, vasoactive agents, and growth factors. In addition, estrogens may exert potent antioxida nt actions in the mesangial microenvironment, which may contribute to the protective effect of female gender. (C) 1995 by the National Kidne y Foundation, Inc.