It has long been known that the female sex is associated with a better clinical outcome in
chronic renal diseases. Although many experimental, clinical, and epidemiological studies in adults have attempted to explain the difference in
disease progression between females and males, a definitive understanding of the underlying mechanisms is still lacking.
Hormone-modulating
therapies are being increasingly used for various indications (such as post-menopausal
hormone replacement, estrogen- or
androgen-receptor antagonists for
cancer therapy). Therefore, a deeper knowledge of the interaction between sexual
hormones and progression of
kidney disease is important, as
hormone-modulating
therapy for non-renal indication may influence both kidney structure and function. In addition, specific modulation of the sexual
hormone system, such as the use of
selective estrogen receptor modulators, may represent a therapeutic option for patients with renal diseases. Although conclusive data on this topic in the pediatric population are still lacking, the aim of this review is to familiarize pediatric nephrologists with gender-specific differences in renal physiology, pathophysiology, and the progression of
kidney diseases. Experimental models that analyze the effects of sexual
hormones on renal structure and function are discussed. It is hoped that this review will stimulate researchers to focus on pediatric studies that will provide a deeper insight into the interaction of gender
hormones and the kidney both before and during puberty.