Health and Me

Ishita Roy

How Does Your Gender Impact You Kidney Health, Explains Doctor

<span>Kidney</span> disease rarely announces itself loudly. Many people discover it only after significant damage has already occurred. According to Dr Mitesh Makwana, Consultant Nephrology at Manipal Hospital, who wrote in <em>The Week</em> one often overlooked factor is gender. Biology, hormones, social behavior and access to healthcare all influence how kidney disease develops, progresses and is treated.

Globally, research published in <em>The Lancet </em>and the<em> International Society of Nephrology</em> estimates that chronic kidney disease affects roughly 1 in 10 adults. Yet the pattern is not the same in men and women.

<h2>Biology And Hormones Shape Risk Differently</h2>

Although kidneys perform identical functions in both sexes, the way they age and respond to stress differs.

Dr Makwana explains that estrogen in women appears to protect kidney filtration units by reducing inflammation and scarring. Testosterone, on the other hand, increases activity of the renin angiotensin aldosterone system, which raises blood pressure inside the kidney and increases protein leakage in urine.

This partly explains a common observation in nephrology clinics. Women develop chronic kidney disease more frequently, but men tend to reach kidney failure faster.

A large European CKD registry analysis has shown that men progress to end stage kidney disease nearly 1.5 times faster than women once damage begins.

<h3>Certain conditions are also gender linked:</h3>

<strong>Women:</strong> lupus nephritis, recurrent urinary infections, pregnancy related kidney injury

<strong>Men: </strong>IgA nephropathy, polycystic kidney disease, hypertension related kidney damage

Pregnancy adds another unique risk. Preeclampsia, gestational diabetes and severe hypertension can permanently damage kidneys. Women who already have protein in urine face higher chances of fetal growth restriction and pregnancy complications.

Women experience urinary tract infections far more frequently because the urethra is shorter and closer to the anal canal. Repeated infections can gradually scar the kidneys.

However, when infections occur in men, they are often detected late and tend to be more severe. Clinically, men with untreated infections are more likely to present with advanced kidney damage.

<h2>Lifestyle Differences Affect Diagnosis Timing</h2>

Lifestyle habits significantly influence outcomes.

Dr Makwana notes that men commonly delay health checkups, smoke more and consume higher amounts of alcohol. This increases risk factors like high blood pressure and diabetes, the two leading causes of kidney failure worldwide.

Women face a different challenge. Many prioritize family health over their own and ignore fatigue or swelling until daily functioning is affected. Studies from rural India have also shown that anaemia and malnutrition during pregnancy increase the risk of acute kidney injury in women.

Despite different behaviors, both groups often reach hospitals late, missing the window for early treatment.

<h2>Chronic Diseases Behave Differently In Men And Women</h2>

Diabetes and hypertension account for nearly 70 per cent of kidney failure cases globally, according to the Global Burden of Disease study. But progression varies.

Women often show mild or borderline abnormalities in early tests, delaying diagnosis. Men experience faster decline once disease begins, making early monitoring critical.

This is why nephrologists stress gender sensitive screening rather than a one size fits all approach.

<h2>Treatment Gap And Transplant Imbalance</h2>

Gender differences continue even after diagnosis.

Across many countries, women donate kidneys more often but receive fewer transplants. Social factors, economic dependency and delayed referrals contribute to this imbalance.

Women are also less likely to start dialysis early and more prone to complications such as low blood pressure during sessions due to vascular access challenges.

Kidney disease is preventable or controllable when detected early. Screening becomes especially important for:

<ul><li>diabetics</li><li>hypertensive patients</li><li>pregnant women with high blood pressure</li><li>people with family history of kidney disease</li></ul>

Simple urine and blood tests can prevent dialysis or transplant in many cases.

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Kidney disease rarely announces itself loudly. Many people discover it only after significant damage has already occurred. According to Dr Mitesh Makwana, Consultant Nephrology at Manipal Hospital, who wrote in The Week one often overlooked factor is gender. Biology, hormones, social behavior and access to healthcare all influence how kidney disease develops, progresses and is treated.Globally, research published in The Lancet and the International Society of Nephrology estimates that chronic kidney disease affects roughly 1 in 10 adults. Yet the pattern is not the same in men and women.Biology And Hormones Shape Risk DifferentlyAlthough kidneys perform identical functions in both sexes, the way they age and respond to stress differs.Dr Makwana explains that estrogen in women appears to protect kidney filtration units by reducing inflammation and scarring. Testosterone, on the other hand, increases activity of the renin angiotensin aldosterone system, which raises blood pressure inside the kidney and increases protein leakage in urine.This partly explains a common observation in nephrology clinics. Women develop chronic kidney disease more frequently, but men tend to reach kidney failure faster.A large European CKD registry analysis has shown that men progress to end stage kidney disease nearly 1.5 times faster than women once damage begins.Certain conditions are also gender linked:Women: lupus nephritis, recurrent urinary infections, pregnancy related kidney injuryMen: IgA nephropathy, polycystic kidney disease, hypertension related kidney damagePregnancy adds another unique risk. Preeclampsia, gestational diabetes and severe hypertension can permanently damage kidneys. Women who already have protein in urine face higher chances of fetal growth restriction and pregnancy complications.Infections And Anatomy MatterWomen experience urinary tract infections far more frequently because the urethra is shorter and closer to the anal canal. Repeated infections can gradually scar the kidneys.However, when infections occur in men, they are often detected late and tend to be more severe. Clinically, men with untreated infections are more likely to present with advanced kidney damage.Lifestyle Differences Affect Diagnosis TimingLifestyle habits significantly influence outcomes.Dr Makwana notes that men commonly delay health checkups, smoke more and consume higher amounts of alcohol. This increases risk factors like high blood pressure and diabetes, the two leading causes of kidney failure worldwide.Women face a different challenge. Many prioritize family health over their own and ignore fatigue or swelling until daily functioning is affected. Studies from rural India have also shown that anaemia and malnutrition during pregnancy increase the risk of acute kidney injury in women.Despite different behaviors, both groups often reach hospitals late, missing the window for early treatment.Chronic Diseases Behave Differently In Men And WomenDiabetes and hypertension account for nearly 70 per cent of kidney failure cases globally, according to the Global Burden of Disease study. But progression varies.Women often show mild or borderline abnormalities in early tests, delaying diagnosis. Men experience faster decline once disease begins, making early monitoring critical.This is why nephrologists stress gender sensitive screening rather than a one size fits all approach.Treatment Gap And Transplant ImbalanceGender differences continue even after diagnosis.Across many countries, women donate kidneys more often but receive fewer transplants. Social factors, economic dependency and delayed referrals contribute to this imbalance.Women are also less likely to start dialysis early and more prone to complications such as low blood pressure during sessions due to vascular access challenges.Why Early Screening MattersKidney disease is preventable or controllable when detected early. Screening becomes especially important for:diabeticshypertensive patientspregnant women with high blood pressurepeople with family history of kidney diseaseSimple urine and blood tests can prevent dialysis or transplant in many cases.