Kidney disease is a global epidemic and innovations in prevention and treatment are urgently needed. However, current practices in kidney research and care often use a one-size-fits-all approach, which does not address the specific sex- and gender-based differences in physiology, pathophysiology, presentation, choice of therapies, and response to treatments, all of which impact outcomes.

Sex refers to biological factors including genetics, sex steroids, physiology, and anatomy, while gender refers to sociocultural factors such as identity, roles, and relations. These considerations interact with other intersectional factors, including age, race, ethnicity, socioeconomic position, disability status, geographic location, and resource setting, to influence contributors to initiation, progression, and complications of kidney disease.

In this special Seminars in Nephrology issue, how sex and gender influence kidney health and disease is discussed. García García et al1García GG Iyengar A Kaze F et al.Sex and gender differences in chronic kidney disease and access to care around the globe. provide an overview of how sex and gender affect the risk of kidney disease and access to kidney care through a global lens. Although X-linked kidney disorders primarily manifest clinically in males, Quinlan and Rheault2X-Linked kidney disorders in women. review the phenotype of X-linked kidney diseases in females who more often are carriers. Hecking et al3Hecking M Hödlmoser S Ahmed SB Carrero JJ The other way around: living with chronic kidney disease from the perspective of men. discuss the accelerated progression of kidney disease to kidney failure in men compared with women, underscoring the need for more tailored preventative and management strategies. Collister et al4Collister D Krakowsky Y Potter E Millar AC Chronic kidney disease in the transgender, nonbinary, or gender diverse person. provide an overview of care of transgender and gender-diverse individuals living with kidney disease and highlight the paucity of research in this area informing care of this growing population. Dumanski et al5Dumanski SM Eckersten D Piccoli GB Reproductive health in chronic kidney disease: the implications of sex and gender. explore the impact of both sex and gender on reproductive health in individuals living with kidney disease. Wylde et al6Wyld MLR Mata NLDL Viecelli A et al.Sex-based differences in risk factors and complications of chronic kidney disease. provide an overview of how sex and gender may impact both the risk and complications of kidney disease. Diabetes parallels kidney disease as a global epidemic, and Sridhar et al7Sridhar VS Yau K Benham JL et al.Sex and gender related differences in diabetic kidney disease. discuss how sex and gender impact the pathophysiology, treatment, and outcomes of diabetic kidney disease. Autoimmune disorders disproportionately affect the female population, and Beckwith et al8Beckwith H Lightstone L McAdoo S Sex and gender in glomerular disease. review sex and gender differences in the pathophysiology, prevalence, treatment, and outcomes of glomerular diseases. People living with kidney disease are at high cardiovascular risk, and Yi and Levin9Sex, gender, and cardiovascular disease in chronic kidney disease. discuss how cardiovascular disease differs by sex and gender in the pathophysiology, presentation, and outcomes in the general population, with a focus on the lack of incorporation of these important factors in studies including populations with kidney disease. Neugarten and Golestaneh10Sex differences in acute kidney injury. discuss how acute kidney injury differs by sex, and how differing cut-off values and definitions have important implications for diagnosis and treatment, as well as estimates of incidence and prevalence. Women are more likely to be a kidney donor, and men are more likely to be a kidney transplant recipient. Katz-Greenberg and Shah11Sex and gender differences in kidney transplantation. discuss how sex and gender impact kidney transplantation from the perspective of both donation and receipt of a transplant. The prevalence of kidney stones is increasing, particularly in women. Ferraro et al12Ferraro PM Cunha TdS Curhan GC Sex differences and the risk of kidney stones. discuss how sex and gender impact the risk, as well as the response to treatment, of kidney stones.Every cell has a sex, and every person is gendered.13

Science is better with sex and gender. Canadian Instititutes of Health Research Institute of Gender and Health Strategic Plan 2018-2023. 2022. Accessed May 16, 2022. https://cihr-irsc.gc.ca/e/51310.html.

Our hope is that this special issue will help prompt a paradigm shift in how we as a nephrology community understand knowledge gaps, approach study design, analysis and reporting, and care for those living with kidney disease, with the ultimate goal of achieving “Kidney Health for All.”REFERENCESGarcía GG Iyengar A Kaze F et al.

Sex and gender differences in chronic kidney disease and access to care around the globe.

Semin Nephrol. 42: 101-113

X-Linked kidney disorders in women.

Semin Nephrol. 42: 114-121Hecking M Hödlmoser S Ahmed SB Carrero JJ

The other way around: living with chronic kidney disease from the perspective of men.

Semin Nephrol. 42: 122-128Collister D Krakowsky Y Potter E Millar AC

Chronic kidney disease in the transgender, nonbinary, or gender diverse person.

Semin Nephrol. 42: 129-141Dumanski SM Eckersten D Piccoli GB

Reproductive health in chronic kidney disease: the implications of sex and gender.

Semin Nephrol. 42: 142-152Wyld MLR Mata NLDL Viecelli A et al.

Sex-based differences in risk factors and complications of chronic kidney disease.

Semin Nephrol. 42: 153-169Sridhar VS Yau K Benham JL et al.

Sex and gender related differences in diabetic kidney disease.

Semin Nephrol. 42: 170-184Beckwith H Lightstone L McAdoo S

Sex and gender in glomerular disease.

Semin Nephrol. 42: 185-196

Sex, gender, and cardiovascular disease in chronic kidney disease.

Semin Nephrol. 42: 197-207

Sex differences in acute kidney injury.

Semin Nephrol. 42: 208-218

Sex and gender differences in kidney transplantation.

Semin Nephrol. 42: 219-229Ferraro PM Cunha TdS Curhan GC

Sex differences and the risk of kidney stones.

Semin Nephrol. 42: 230-235

Science is better with sex and gender. Canadian Instititutes of Health Research Institute of Gender and Health Strategic Plan 2018-2023. 2022. Accessed May 16, 2022. https://cihr-irsc.gc.ca/e/51310.html.

World kidney day 2022: kidney health for all. Accessed May 16, 2022. https://www.worldkidneyday.org.

Article InfoFootnotes

Financial disclosure and conflict of interest statements: none.

Identification

DOI: https://doi.org/10.1016/j.semnephrol.2022.04.013

Copyright

© 2022 Elsevier Inc. All rights reserved.

ScienceDirectAccess this article on ScienceDirect Related Articles