Approximately 10% of people worldwide suffer from Chronic Kidney Disease (CKD). Experts predict that by 2040, kidney disease could even become one of the five leading causes of death worldwide. In Germany, approx. 100,000 people depend on dialysis or a kidney transplant (KTx) to survive. Moreover, CKD places financial burdens on global healthcare system. For example, annual costs reaching 24 billion EUR resp. approx. 12% of total healthcare expenditures in Germany.
Gender Gap in Medicine
You might know Marie Curie. She discovered together with her husband Pierre Curie radiation of certain chemicals, such as radium and polonium in 1898. However, her scientific findings were attributed to her husband, but not her until recently. More than a century later, the world has changed, hasn’t it?
Today, clinical trials are an important aspect in the course of the development of new pharmaceuticals. However, the clinical trial design often still neglects gender- and sex-specifics due to their complexity. As a result, pharmaceuticals have individual effects per gender, which is not investigated in the required granularity, yet.
Sex‑Specific Differences in Kidney Transplantation
If it comes to the need of rental replacement therapy and a kidney transplantation, you might discover additional gender gaps.
Amongst others, women have a statistically higher risk for developing CKD, in particular early-stage CKD. However, men often experience a faster decline in kidney function, influenced by hormonal factors and lifestyle patterns.
Despite benefiting just as much as men from KTx, women are still placed on transplant waiting lists less frequently and receive transplants less often, with their chances being up to 20% lower. Furthermore, women receive fewer organs from deceased donors, even though access to living donor kidneys is roughly equal.
In everyday clinical practice, women frequently receive fewer health checkups, fewer medications, and dialysis less often than men—even when the medical need is the same. Furthermore, older women tend to choose conservative care rather than dialysis more often, sometimes because of personal preferences but sometimes due to a lack of comprehensive medical counseling.
Transplantation Outcomes: Similar Results, but Different Risks
Long‑term studies indicate that the KTx outcome can be similar for women and men. Nevertheless, the biological and medical factors that influence outcomes often differ significantly. As a result, the proper function of the transplanted organ functions might be affected.
Frequently, women have a more active immune system compared to men. As a result, the risk of transplant rejection is increased in woman. Men and women also metabolize required immunosuppressive medications differently, which means that sex-specific dosage adjustments might help to achieve better results. Woman, who gave birth might be affected by antibodies formed during pregnancy. As a result, the search for a compatible donor kidney for women might be more complicated.
Why Your Sex Matters
Sex‑specific differences influence how kidney diseases develop, the discovery of the disease, its progression, as well as treatment options and chance for receiving a compatible donor organ. Many of these differences were overlooked for a long time. To ensure the best possible care for all patients, it is important to recognize these disparities and integrate them into medical decision‑making, counseling, and treatment strategies.
GeGe4Nephro: Research for Better Gender-specific Health of Kidney Transplant Patients
The GeGe4Nephro research consortium is developing an AI‑based prediction model that helps physicians better assess an individual’s risk of complications after a kidney transplant, such as the risk of developing cancer. This allows preventive measures—like targeted skin‑cancer screenings—to be used in a more personalized and responsible way. To achieve this, the project is creating an interactive tool that presents personal risk profiles in real time for each patient. The tool is being tested in clinical practice and is planned to become an integral part of routine medical care in the future.
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