Advances in understanding the impact of sex on kidney health and disease.

Biological differences exist between males and females in kidney structure and function, leading to sex heterogeneity in the presentation and outcomes of chronic kidney disease (CKD) and response to novel therapeutics. However, treatment guidelines ignore sex-specific differences. This Series paper provides an integrated discussion of the complexity of sex differences in the context of kidney health and disease, from biology through clinical characteristics, treatment, evidence generation, and reporting. Throughout, we consider the effect of genetics, epigenetic regulation, and the role of sex hormones. We highlight substantial opportunities that exist for policy makers, scientific organisations, journal editors, funders, and individuals to change the current paradigm. Strategic and systematic acknowledgment, exploration, and reporting of these differences is needed in future research to continue to advance our understanding of pathophysiology, diagnostics, and novel therapeutics for CKD.