KDIGO looks at important issues for women and kidney health
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Kidney diseases are biologically modulated by sex and can be culturally modulated by gender. There are well-described sex- and gender-specific differences in the prevalence and prognosis of some kidney diseases, the prototype of which is lupus nephritis.
Access to health care may vary because of social, economic and cultural factors. In many settings, women with kidney failure have lower access to kidney transplantation compared with men, while at the same time, women are more often living kidney donors.
These topics were part of a recent gathering organized by Kidney Disease: Improving Global Outcomes (KDIGO) as part of its Controversies Conferences. The meeting was a step toward improving knowledge and ability to help women with and at risk for chronic kidney disease around the world.
More than 75 experts from more than 30 countries attended the conference held in Athens, Greece, including adult and pediatric nephrologists, epidemiologists, obstetricians, gynecologists, neonatologists, dietitians, midwives and patients.
Reproductive health
In addition to discussion on sex and gender disparities in kidney care and access, conference attendees also debated best practices for reproductive health and pregnancy complications in women with CKD. This population may have reduced fertility, early menopause, alterations in body image, and reduction in sexual desire and satisfaction.
Pregnant women with CKD, even at early stages, have an increased risk for early delivery and developing hypertensive disorders of pregnancy. The relationship between hypertensive disorders of pregnancy, preeclampsia and pregnancy complications is complex: kidney diseases are present and often unrecognized in up to 20% of women with preeclampsia, while preeclampsia and other pregnancy-related conditions are among the most common causes of AKI in young women.
In addition to scientific and clinical experts, four women with CKD described their own journeys through complicated pregnancies and shared their experiences as patients throughout the meeting.
Future research
The conference highlighted the need for future research on many issues of kidney health in women, including sex and gender differences in CKD epidemiology, management and outcomes; reproductive care of women across all stages of CKD; use of biomarkers for early diagnosis of preeclampsia and management of high-risk pregnancies; prevention of AKI in pregnancy; timing of delivery in high-risk pregnancies; and protection of future maternal-child health, after a pregnancy complicated by preeclampsia or related disorders. In each of these important discussions, conference organizers identified key knowledge gaps to inform future research.
Our shared commitment for this gathering was to have multidisciplinary discussions to advance nephrology and improve the care of women with CKD and their children. When the final conference reports are published later this year, KDIGO will make a significant effort to disseminate the observations to support education and awareness programs and to guide future research to improve women’s kidney health worldwide.
- For more information:
- Giorgina B. Piccoli, MD, is an associate professor in nephrology at University of Angers, France, and the head of the nephrology unit at Centre Hospitalier, Le Mans, France.
- Christina M. Wyatt, MD, is an associate professor of medicine and nephrology at Duke Health and a member of the Duke Clinical Research Institute.
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