Sex-Related Aspects in Diabetic Kidney Disease—An Update

Abstract

Differences between the sexes exist in many diseases, and in most cases, being a specific sex is considered a risk factor in the development and/or progression. This is not quite so clear in diabetic kidney disease (DKD), the development and severity of which depends on many general factors, such as the duration of diabetes mellitus, glycemic control, and biological risk factors. Similarly, sex-specific factors, such as puberty or andro-/menopause, also determine the microvascular complications in both the male and female sex. In particular, the fact that diabetes mellitus itself influences sex hormone levels, which in turn seem to be involved in renal pathophysiology, highlights the complexity of the question of sex differences in DKD. The major objective of this review is to summarize and simplify the current knowledge on biological sex-related aspects in the development/progression but also treatment strategies of human DKD. It also highlights findings from basic preclinical research that may provide explanations for these differences.

Association between serum total bilirubin and diabetic kidney disease in US diabetic patients

“…Notably, a higher STB level (> 11.98 mmol/L) was observed to be associated with a nearly 25% reduced risk of DKD in males, whereas no significant correlation was found in females. Importantly, such sex-and agerelated differences in both STB level and DKD prevalence have been widely reported (38)(39)(40), as also reflected in our results (Tables 1 and 2).…”