The Kidney Health Risk Women May Not Be Talking About Enough

Kidney disease can be surprisingly easy to have without knowing it. Your kidneys can lose some of their ability to filter your blood without causing the kind of obvious symptoms that would send you straight to the doctor, which means early detection often depends on knowing what to look for before you feel anything is wrong.

For women, that may be especially important. About 1 in 10 women worldwide lives with chronic kidney disease, yet diagnosis is often delayed. And a new scientific statement from the American Heart Association suggests part of the reason may come down to something we don't talk about enough: Women's kidney health isn't always the same as men's.

The new statement, published in Circulation, brings together what researchers currently know about kidney health in women, including why kidney disease may be recognized later and why women don't always receive the same treatment as men.

One particularly interesting issue comes down to a blood test many of us have probably had without thinking much about it.

Kidney function is commonly estimated using creatinine, a waste product produced by your muscles. Doctors use your creatinine level, along with factors like age and sex, to calculate your estimated glomerular filtration rate, or eGFR, which gives them an idea of how well your kidneys are filtering your blood.

But creatinine is closely tied to muscle mass. Because women tend to have less muscle mass than men, they generally produce less creatinine. The authors point out that this can make kidney function harder to estimate accurately in some women, potentially contributing to kidney disease being misclassified or recognized later.

The other piece I found particularly interesting is how closely kidney health overlaps with reproductive health.

Pregnancy puts major demands on the kidneys. During pregnancy, kidney filtration increases substantially as the body adapts to support both mother and baby. That also means pregnancy complications can sometimes provide clues about health risks that extend well beyond those nine months.

Preeclampsia, for example, is associated with a higher future risk of kidney disease as well as heart disease and stroke. The statement also highlights PMOS, early menopause, and lupus as conditions associated with kidney health. Natural menopause before age 45 and surgical removal of the ovaries before age 50 have both been linked with a higher risk of CKD.

So what do you actually do with all of this?

If you have risk factors for kidney disease, it's worth talking with your doctor about whether your kidneys are being adequately monitored. Diabetes is the leading cause of CKD worldwide, and high blood pressure is another important risk factor. Kidney disease is also closely connected with cardiovascular health, contributing to heart disease and stroke risk.

Kidney screening itself doesn't have to be complicated. Blood testing can estimate how well your kidneys are filtering, while a urine test can look for albumin, a protein that can leak into urine when the kidneys' filtering system has been damaged.

We tend to separate reproductive health, metabolic health, heart health, and kidney health into their own boxes. But your body doesn't work that way.

For women especially, pregnancy history, hormones, muscle mass, blood pressure, blood sugar, and kidney function can all tell pieces of the same larger story. The challenge is making sure we're actually putting those pieces together.