Women Face Delays and Disparities in CKD Care

A new American Heart Association (AHA) scientific statement highlights delayed chronic kidney disease (CKD) diagnosis and unequal access to dialysis and transplantation among women. The statement, published in Circulation, calls for kidney care and research that better account for female biology, reproductive life stages, and social factors.

CKD affects approximately 1 in 10 women worldwide, according to the statement. Its seven identified challenges include women’s underrepresentation in clinical trials, delayed referrals, reduced treatment access, adverse pregnancy outcomes, menopause-related considerations, more adverse medication effects, and lower kidney-transplant rates.

Creatinine-based estimates may contribute to underrecognition because women typically have less muscle mass and may produce less creatinine. Women may also absorb, distribute, metabolize, and eliminate medications differently than men. The statement calls for greater enrollment of women in CKD trials and for results to be analyzed by sex and reproductive-health factors.

The statement also emphasizes connections between kidney and reproductive health. Pregnancy in women with CKD may increase the risks of disease progression and pregnancy complications. At the same time, preeclampsia may indicate increased future risks of kidney disease, heart disease, and stroke among women without CKD. Natural menopause before age 45 and surgical removal of the ovaries before age 50 are each associated with higher CKD risk. Polycystic ovary syndrome and lupus are also linked to increased risk.

Treatment disparities extend to kidney replacement therapy. Women tend to start dialysis at a lower level of kidney function than men and are less likely to receive a kidney transplant; globally, men receive kidney transplants about 30% more often. The writing group identified reproductive-health assessment in CKD care, greater trial participation, sex-specific analyses, and further study of female biology and life stages as opportunities to improve evidence and care. The AHA noted that scientific statements summarize current knowledge and research needs but do not issue clinical practice recommendations.

Source: American Heart Association. Women’s kidney health may be overlooked, delaying critical prevention and treatment opportunities. News release. American Heart Association; September 17, 2026. Accessed September 17, 2026.