Reframing Women's Health in Kidney Disease: Sex Differences, Gender Disparities, and Clinical Imperatives - Introduction to a Special Series.

Abstract

Kidney disease has often been approached as affecting women and men similarly, yet important differences in sex-specific biology and gender-related social experiences shape risk, recognition, and treatment for women with CKD. Women more commonly have early-stage CKD but progress more slowly to kidney failure, a pattern influenced by hormonal factors and complicated by diagnostic practices that may delay detection. Evidence also suggests women receive lower-quality CKD care than men, including fewer nephrology referrals and lower use of guideline-recommended therapies. Pregnancy-related exposures, particularly adverse pregnancy outcomes such as preeclampsia, are associated with substantially increased long-term risk of CKD and ESKD, yet structured postpartum kidney follow-up is uncommon. Menopause may represent a key inflection point for CKD progression and bone health. Additional disparities affect transplant access, and cancer survivorship introduces underrecognized renal risks. This special series examines these life stages and clinical domains and outlines practice-relevant, sex- and gender-informed approaches to improve equity and outcomes.