Sex differences in renal electrolyte transport

Curr Opin Nephrol Hypertens. 2023 Sep 1;32(5):467-475. doi: 10.1097/MNH.0000000000000909. Epub 2023 Jun 23.

Abstract

Purpose of review: Women experience unique life events, for example, pregnancy and lactation, that challenge renal regulation of electrolyte homeostasis. Recent analyses of nephron organization in female vs. male rodent kidneys, revealed distinct sexual dimorphisms in electrolyte transporter expression, abundance, and activity. This review aims to provide an overview of electrolyte transporters' organization and operation in female compared with the commonly studied male kidney, and the (patho)physiologic consequences of the differences.

Recent findings: When electrolyte transporters are assessed in kidney protein homogenates from both sexes, relative transporter abundance ratios in females/males are less than one along proximal tubule and greater than one post macula densa, which is indicative of a 'downstream shift' in fractional reabsorption of electrolytes in females. This arrangement improves the excretion of a sodium load, challenges potassium homeostasis, and is consistent with the lower blood pressure and greater pressure natriuresis observed in premenopausal women.

Summary: We summarize recently reported new knowledge about sex differences in renal transporters: abundance and expression along nephron, implications for regulation by Na + , K + and angiotensin II, and mathematical models of female nephron function.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Electrolytes / metabolism
  • Female
  • Humans
  • Kidney* / metabolism
  • Male
  • Membrane Transport Proteins / metabolism
  • Nephrons / metabolism
  • Sex Characteristics*
  • Sodium / metabolism

Substances

  • Membrane Transport Proteins
  • Sodium
  • Electrolytes