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. 2009 Nov;29(6):569-78.
doi: 10.1016/j.semnephrol.2009.07.003.

Sexual dimorphism, the aging kidney, and involvement of nitric oxide deficiency

Chris Baylis  1
Affiliations

Sexual dimorphism, the aging kidney, and involvement of nitric oxide deficiency

Chris Baylis. Semin Nephrol. 2009 Nov.

Abstract

Females develop less age-dependent loss of renal function, in part because of cardiorenal protective effects of estrogens. The low androgen level in women also may be protective, although the animal and clinical data are controversial. Both estrogen and androgens act through multiple mechanisms, sometimes beneficial, sometimes damaging, which makes it difficult to predict the impact of hormone replacement therapy in an aging population. Nitric oxide (NO) deficiency contributes to age-dependent cardiovascular risk and kidney damage in animal models. The increased oxidative stress of aging impacts at multiple sites in the NO biosynthetic pathway to decrease NO production/action. Endothelial dysfunction develops with aging and is delayed in women, in association with a delayed increase in asymmetric dimethylarginine. Animal data suggest that the aging kidney develops NO deficiency because of changes in the neuronal NO synthase. Relative preservation of NO production in females contributes to the better cardiovascular and renal responses to aging.

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Figures

Figure 1
Figure 1
GFR (measured by inulin clearances) in cross-sectional studies in normal men and women of different ages who were evaluated as potential kidney transplant donors. Reprinted with permission from Berg.
Figure 2
Figure 2
Afferent and efferent arteriolar resistance (RA and RE, respectively) and glomerular blood pressure (PGC) in young adult (~3-4 mo) and older (~18-20 mo) intact male and female MW rats. Data from Baylis.
Figure 3
Figure 3
The 24-hour urinary excretion of NO2 + NO3 (NOX), UNOXV (upper panel) and the percentage of damaged glomeruli (ie, those showing segmental and global sclerosis) in young adult (3-5 mo) and old (18-22 mo) male (M) and female (F) SD rats. Data from Erdely et al and reprinted with permission from Baylis.
Figure 4
Figure 4
A regression analysis of ADMA levels and age, based on sex, was performed on data from 500 healthy, nonsmoking, nonobese subjects ages 19 to 75 years. Reprinted with permission from Schulze et al.
See this image and copyright information in PMC

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