Published online before print February 7, 2008, doi: 10.1161/HYPERTENSIONAHA.107.101345
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(Hypertension. 2008;51:1000.)
© 2008 American Heart Association, Inc.
Go Red Editorial Commentaries |
Sex and the Kidney
From the Department of Physiology and Biophysics and Center for Excellence in Cardiovascular-Renal Research, University of Mississippi Medical Center, Jackson.
Correspondence to Jane F. Reckelhoff, Department of Physiology and Biophysics, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39216-4505. E-mail jreckelhoff@physiology.umsmed.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Several lines of evidence indicate that there are sex differences in the incidence and severity of cardiovascular and renal disease. Men are more prone to develop chronic kidney disease (CKD) and to progresses to end-stage renal disease than are women, when all-cause incidence rates are considered.1 When a primary diagnosis is taken into account, this assertion holds true for many causes of CKD, such as IgA or membranous nephropathy, hypertensive nephropathy, or polycystic kidney disease.2 However, in the case of diabetic renal disease, the sexual dimorphism favoring women is not as clear cut, and clinical data are conflicting.2
Extensive experimental studies document a role for sex hormones, androgens and estrogens, in the regulation of cardiovascular and renal physiology and pathology. Generally, beneficial effects of estrogens were considered to underlie the relative protection of women against cardiovascular disease and to explain the loss of such protection after menopause. However, recent data from the Women’s Health Initiative study disproved the expected beneficial results of female sex hormone replacement on primary events associated with cardiovascular disease. The alternative explanation, that the presence of androgens and not the absence of estrogens predisposes men to developing cardiovascular disease and CKD, has recently received increasing attention from basic and clinical investigators, but preconceived notions and entrenched dogma in this field have been difficult to overcome.3
Androgens have been demonstrated to affect multiple hormonal and autacoid systems, which participate in the regulation of blood pressure and renal function. Testosterone stimulates various key components of the systemic and
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