Women and Kidney Disease: Reflections on World Kidney Day 2018

Kidney Health and Women's Health: A Case for Optimizing Outcomes for Present and Future Generations

Giorgina B. Piccoli; Mona Alrukhaimi; Zhi-Hong Liu; Elena Zakharova; Adeera Levin

Disclosures

Nephrol Dial Transplant. 2018;33(2):189-193. 

In This Article

Abstract and Introduction

Abstract

Chronic kidney disease (CKD) affects ~10% of the world's adult population: it is one of the top 20 causes of death worldwide and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day coincide in 2018, thus offering an opportunity to reflect on the importance of women's health, and specifically their kidney health, on the community and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply these learnings more broadly. Girls and women, who make up ~50% of the world's population, are important contributors to society and their families. Gender differences continue to exist around the world in access to education, medical care and participation in clinical studies. Pregnancy is a unique state for women, offering an opportunity for the diagnosis of kidney disease, and also a state where acute and chronic kidney diseases may manifest and that may impact future generations with respect to kidney health. There are various autoimmune and other conditions that are more likely to impact women with profound consequences for childbearing and on the fetus. Women have different complications on dialysis than men and are more likely to be donors than recipients of kidney transplants. In this editorial we focus on what we do and do not know about women, kidney health and kidney disease and what we might learn in the future to improve outcomes worldwide.

Introduction

Chronic kidney disease (CKD) affects ~10% of the world's adult population: it is one of the top 20 causes of death worldwide[1] and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day coincide in 2018, thus offering an opportunity to reflect on the importance of women's health, and specifically their kidney health, on the community and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply these learnings more broadly.

Girls and women, who make up ~50% of the world's population, are important contributors to society and their families. Besides childbearing, women are essential in childrearing and contribute to sustaining family and community health. Women in the 21st century continue to strive for equity in business, commerce and professional endeavors, while recognizing that in many situations equity does not exist. In various locations around the world, access to education and medical care is not equitable among men and women; women remain underrepresented in many clinical research studies, thus limiting the evidence based on which to make recommendations to ensure best outcomes (Figure 1).

Figure 1.

Sex differences throughout the continuum of CKD care. SLE, systemic lupus erythematosus; RA, rheumatoid arthritis; SS, systemic scleroderma; AKI, acute kidney injury; CKD, chronic kidney disease; AI, autoimmune; AVF, arteriovenous fistula; HD, hemodialysis; KT, kidney transplant.

In this editorial we focus on what we do and do not know about women's kidney health and kidney disease and what we might learn in the future to improve outcomes for all.

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