Collister David, Levin Adeera
Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, Division of Nephrology, University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada.
J Clin Invest. 2025 May 1;135(9). doi: 10.1172/JCI191907.
There are known sex (i.e., biological) and gender (i.e., social) differences in the epidemiology and outcomes of chronic kidney disease. In this issue of the JCI, van Eeghen et al. provide a prospective multicenter observational study of transgender individuals initiating masculinizing and feminizing hormone therapy. Testosterone and estrogen with testosterone blockade had differential effects on kidney physiology including renal plasma blood flow, measured glomerular filtration rate, tubular biomarkers, and various proteins involved in inflammatory and repair pathways. The findings suggest that estrogen is renoprotective and that testosterone may be harmful to kidney function, but requires validation in larger, more diverse cohorts. The insights gained also need to be examined in the context of both endogenous and exogenous sex hormones in individuals over the life cycle.
慢性肾脏病的流行病学和预后存在已知的性别（即生物学）和社会性别（即社会层面）差异。在本期《临床研究杂志》（JCI）中，范·埃根等人对开始接受男性化和女性化激素治疗的跨性别者进行了一项前瞻性多中心观察性研究。睾酮以及联合睾酮阻断的雌激素对肾脏生理功能有不同影响，包括肾血浆血流量、测量的肾小球滤过率、肾小管生物标志物以及参与炎症和修复途径的各种蛋白质。研究结果表明，雌激素具有肾脏保护作用，而睾酮可能对肾功能有害，但这需要在更大、更多样化的队列中进行验证。所获得的见解还需要在个体生命周期内的内源性和外源性性激素背景下进行研究。
