Chronic kidney disease (CKD) affects approximately one in ten women worldwide, but diagnosis is often delayed and women are less likely to receive critical treatments such as dialysis or a kidney transplant compared to men, according to a new American Heart Association scientific statement published today in the Association's flagship journal Circulation. The statement, titled "Women's Kidney Health in Focus," highlights seven key challenges women face in kidney care, including underrepresentation in clinical trials, less treatment access, delayed referrals, adverse pregnancy outcomes, menopause, more adverse effects of kidney treatment medication, and lower rates of kidney transplant.
"Many cases go undiagnosed in women because common tests and research do not always reflect women's biology and life stages," said Eman Y. Gohar, Ph.D., M.S., FAHA, volunteer chair of the scientific statement writing group. "Biological differences include genetics, sex chromosomes, hormones, immune-system responses and differences in how the body processes and responds to medication," Gohar said. "We also need to acknowledge female-specific factors that do not apply in the same way to male patients. These include menstrual health, pregnancy, postpartum changes and menopause as well as socioeconomic factors like financial barriers or cultural expectations."
The statement points out that kidney function is commonly estimated using creatinine, a waste product generated by muscle. Because women typically have less muscle mass, these estimates may not accurately reflect kidney function, leading to misclassification or delayed recognition of kidney disease. "Women are not simply smaller versions of men," said Gohar, an assistant professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee. "Their biology, reproductive life stages and responses to medication may differ, and those differences need to be reflected in clinical care and research."
Kidney and reproductive health are closely connected, according to the statement. Pregnancy in women with CKD may increase the risk of kidney disease progression and pregnancy complications. In women without CKD, Adverse pregnancy outcomes such as preeclampsia may signal an increased risk of future kidney disease, heart disease and stroke. Natural menopause before age 45 and surgical removal of the ovaries before age 50 are each linked with a higher risk of CKD. Other factors contributing to CKD after menopause include increases in obesity, type 2 diabetes and high cholesterol.
Women also face gaps in access to timely kidney care and transplants. They tend to begin dialysis at a lower level of kidney function compared to men, indicating a delay in treatment initiation, and are less likely to receive a kidney transplant. Globally, men receive kidney transplants about 30% more often than women; in some low- and middle-income countries, the gap is more than 10-to-1. Poverty, limited health literacy, caregiving responsibilities, cultural expectations, limited support and treatment costs may delay diagnosis or make specialist care harder to reach.
CKD is a major contributor to heart disease and stroke risk, which is why it is part of cardiovascular-kidney-metabolic (CKM) syndrome. Diabetes, another component of CKM syndrome, is the leading cause of CKD worldwide. Among people with diabetes, some evidence suggests women may progress to kidney failure at higher rates than men. The statement identifies research priorities that include enrolling enough women in clinical trials to determine whether treatments affect women and men differently, reporting results by sex and reproductive health-specific factors. The full manuscript will be available online after Sept. 17, 2026, at the manuscript online. Additional resources include a news release on Millions are unaware of heart risks that don’t start in the heart and Must-know facts for women about heart, kidney and metabolic health. The statement also references Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health and the 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines | Circulation. For more information, visit heart.org and stroke.org. The original release is available on www.newmediawire.com.
