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Sex hormones and their influence on chronic kidney disease

Valdivielso, José Manuela; Jacobs-Cachá, Conxitab; Soler, María Joséb,c

Current Opinion in Nephrology and Hypertension: January 2019 - Volume 28 - Issue 1 - p 1–9
doi: 10.1097/MNH.0000000000000463

Purpose of review The majority of end-stage renal disease including dialysis and kidney transplant patients are men. In contrast, the incidence of chronic kidney disease (CKD) is higher in women compared with men. In this review, we dissect the sex hormone levels and its effects on experimental models and patients with CKD.

Recent findings Sex hormones are clearly involved in CKD progression to end-stage renal disease (ESRD). A significant reduction in lipid peroxidation as a mechanism of renoprotection has been observed in kidneys of streptozotocin (STZ)-diabetic ovariectomized rats after estradiol administration. Furthermore, a G-protein-coupled estrogen receptor inhibits podocyte oxidative stress maintaining the integrity of the mitochondrial membrane. Sex hormone depletion has been shown to modulate RAS system and protect against kidney injury in the male STZ-diabetic model. In human primary proximal tubular epithelial cells, a proteomic study showed that dihydrotestosterone dysregulated metabolic, suggesting that the deleterious effect of androgens within the kidney maybe related to altered energy metabolism in renal tubules.

Summary Male gender is associated with worse CKD progression and this fact may be ascribed to sex hormone. Although male hormones exert a deleterious effect in terms of increasing oxidative stress, activating RAS system, and worsening fibrosis within the damaged kidney, female hormones exert a renoprotective effect.

aUnit for Detection and Treatment of Atherothrombotic Diseases, Experimental Nephrology Laboratory, Arnau de Vilanova University Hospital, Biomedical Research Institute of Lleida, Spanish Research Network for Renal Diseases (RedInRen. ISCIII), Lleida

bNephrology Research Group, Vall d’Hebron Research Institute (VHIR)

cNephrology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain

Correspondence to María José Soler, Romeo, Servicio de Nefrología, Hospital General Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. Tel: +34 934 89 30 00; e-mail:

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