Male gender is associated with a more rapid progression of chronic ren
al disease. In various experimental models of renal injury, manipulati
on of the hormonal milieu can replicate the effects of gender on the c
ourse of renal disease. These observations suggest that sex hormones p
er se may be important determinants of the greater susceptibility of t
he male kidney to progressive renal injury. Sex hormones may influence
many of the processes implicated in the pathogenesis of renal disease
progression, including cell proliferation and the synthesis and degra
dation of collagen and proteoglycans. In addition, sex hormones may in
directly influence these processes by modulating the synthesis and rel
ease of vasoactive agents, cytokines, and other growth factors, which
in turn are capable of altering mesangial cell function. Finally, estr
ogens also exert potent antioxidant effects that may contribute to the
protective effect of female gender on the course of renal disease. (C
) 1995 by the National Kidney Foundation, Inc.