Epidemiology and Gender Disparities in Chronic Kidney Disease

Chronic kidney disease (CKD) affects an estimated 8–16 per cent of the global adult population and constitutes a mounting public health burden. Although prevalence is often higher in women, men tend to experience faster progression to end-stage renal disease (ESRD), higher rates of renal replacement therapy initiation and greater cardiovascular mortality. Key risk factors such as hypertension, diabetes and obesity interact with socioeconomic determinants, health‐seeking behaviours and biological differences—including hormonal influences and renal haemodynamics—to shape sex‐specific trajectories. Women frequently exhibit lower awareness of CKD, are under-represented in specialist nephrology care and may face stereotyping or caregiving barriers that delay diagnosis and treatment. Men, by contrast, may defer care until later stages, yet access haemodialysis and transplantation more readily. Global epidemiological patterns vary substantially by region and age, underscoring the need for integrated strategies that address both biological vulnerabilities and gendered social norms to optimise early detection, risk stratification and equitable access to kidney care.

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Epidemiology and Gender Disparities in Chronic Kidney Disease publication trend

The graph below shows the total number of articles in epidemiology and gender disparities in chronic kidney disease across all publications each year (not limited to Nature Index journals).

Technical terms

Estimated glomerular filtration rate (eGFR): An estimate of kidney function derived from serum creatinine, age, sex and sometimes race.

Albuminuria: The presence of albumin in urine, reflecting glomerular damage and a predictor of CKD progression.

CKD stages: Classification of CKD severity from G1 (normal or high eGFR) to G5 (kidney failure) based on eGFR ranges.

Renal replacement therapy: Treatments that substitute for failed kidney function, including haemodialysis, peritoneal dialysis and transplantation.

Subhazard ratio (SHR): A metric in competing-risk analysis estimating the relative incidence of an event (e.g., CKD progression) in the presence of competing outcomes (e.g., death).

References

1. Sex-Specific Differences in Hemodialysis Prevalence and Practices and the Male-to-Female Mortality Rate: The Dialysis Outcomes and Practice Patterns Study (DOPPS). PLOS Medicine (2014).
2. CKD Progression and Mortality Among Men and Women: A Nationwide Study in Sweden. American Journal of Kidney Diseases (2021).
3. Sex differences in chronic kidney disease awareness among US adults, 1999 to 2018. PLOS ONE (2020).
4. Nephrologists’ Perspectives on Gender Disparities in CKD and Dialysis. Kidney International Reports (2021).
5. Chronic kidney disease is more prevalent among women but more men than women are under nephrological care. Wiener klinische Wochenschrift (2022).