Sr. Silbiger et J. Neugarten, THE IMPACT OF GENDER ON THE PROGRESSION OF CHRONIC RENAL-DISEASE, American journal of kidney diseases, 25(4), 1995, pp. 515-533
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.