Top Things to Know: Women’s Kidney Health in Focus
Updated: September 17, 2026
Prepared by Sally S. Wong, PhD, RD, CDN, FAHA, National Sr. Director, Science & Medicine, American Heart Association
- Globally, one in 10 women lives with chronic kidney disease (CKD), which is closely intertwined with cardiovascular risk as part of the cardiovascular-kidney-metabolic syndrome.
- The prevalence of advanced CKD is higher in women than in men; however, the mechanisms underlying this sex-specific disparity remain to be determined.
- The underrepresentation of women and the lack of sex-specific analyses and reporting in clinical trials of CKD therapies limit their informed applicability for women’s kidney health.
- Women living with CKD are at higher risk of adverse pregnancy outcomes and hypertensive disorders of pregnancy, which can in turn accelerate kidney damage and worsen chronic kidney disease progression.
- Women may manifest different responses to pharmacological therapies compared to men but continue to remain underrepresented in clinical trials, and preclinical evidence implicates a role for estrogen receptor signaling in renal physiology and pathophysiology.
- Pregnancy and lactation, which are exclusion criteria in most current clinical trials, are confounding factors impacting the understanding of cardiovascular and renal responses in the short- and long-term.
- Menopause and aging may accelerate CKD progression in women due to declining estradiol and shifts in kidney estrogen receptor profiles.
- Hormonal and immunological factors increase the susceptibility of certain autoimmune kidney diseases in women, most notably lupus nephritis, the renal manifestation of systemic lupus erythematosus.
- Advancing precision kidney medicine for women requires equitable access to kidney care, embedding assessment of reproductive health in chronic care, trial design with adequate power that includes both women and men, and mechanistic studies linking reproductive health to long-term cardiovascular disease and CKD development and progression.
- This scientific statement highlights the pressing need for studying sex-specific pharmacokinetics and pharmacodynamics in CKD therapeutics to develop more sex-specific personalized drug dosing, selection, and risk management strategies.
Citation
Gohar EY, Oh ES, Ahmed SB, Karumanchi SA, Mathew RO, Norouzi S, Piccoli GB, Reckelhoff JF, Vinson A, Yanes Cardozo LL, Shah S; on behalf of the American Heart Association Kidney in Heart Disease Science Committee of the Council on the Kidney in Cardiovascular Disease; Council on Clinical Cardiology; and Council on Lifestyle and Cardiometabolic Health. Women’s kidney health in focus: a scientific statement from the American Heart Association. Circulation.