We’re excited World Kidney Day with its 2018 theme of Kidneys & Women’s Health is upon us and Kidney Month is underway! This made it the ideal time to speak with Can-SOLVE CKD’s new Sex and Gender Lead Dr. Sofia Ahmed recently about what we should be paying attention to when it comes to kidneys and women’s health. We also asked her about where she sees opportunities for her to make a difference with the network and about the value of patient-oriented research.
As one of Canada’s leading experts in sex and gender research for people living with or at risk of kidney disease, Dr. Ahmed says there are a number of times in a woman’s life when we should be considering and studying kidney health issues specific to women. “Pregnancy is an example of a life stage specific to women that can affect kidney function and risk,” says Dr. Ahmed. “Estrogen hormone therapy used at different stages in a woman’s life may have an impact on kidney function.”
Some examples are when younger and middle-aged women are deciding on what kind of contraception to use, when women who have difficulty conceiving are considering In Vitro Fertilization (IVF), and when middle aged and older women are going through menopause, or are post-menopausal, and are considering hormone therapy.
“In all of these cases, women face choices about whether to take estrogen hormones or not and by which route (orally or otherwise), and they and their doctors need to consider the potential impact of each option on the kidneys, balanced with the risk of an unplanned pregnancy,” says Dr. Ahmed.
She and her colleagues have studied oral contraceptives that are more casually known as ‘the pill’. “We’ve found oral contraceptives are associated with more protein in a woman’s urine,” says Dr. Ahmed. “High levels of protein in a person’s urine can lead to faster loss of kidney function. We’re now comparing the impact of oral contraceptives and other kinds of contraceptives on the kidneys, so we can provide women with evidence-based advice on how different contraceptives may affect their kidneys.”
Conversely, women living with kidney disease may be impacted to a greater extent by taking estrogen orally compared to other women. Some studies have taken place to provide evidence of the impact, but overall, Dr. Ahmed says there are more questions than answers.
These topics only cover one angle of sex and gender issues as researchers, health care providers and patients could also benefit from studies about how women are biologically affected by the same treatment options as men (sex differences) as well as how women are culturally affected by the same treatment options (gender differences). This is where Dr. Ahmed is beginning her conversations with other Can-SOLVE CKD researchers who have several kidney research projects underway.
“I’m really excited about the opportunity,” says Dr. Ahmed. “It’s a great chance to collaborate with excellent researchers, and an opportunity to look at their research projects with fresh eyes on issues that are unique to the different sexes and genders.”
Dr. Ahmed has previously worked with cross-disciplinary research groups that include patients, caregivers, health care professionals and policy makers, and she says as a clinician, she hears from patients about what concerns them and what questions they want answered. “I completely see the value of having patients on research teams,” says Dr. Ahmed. “The person who’s living with the disease and the person who’s caring for the person with the disease, they know what questions need to be asked that are relevant to what else is going on in their lives. And when it comes to translating research findings into clinical practice, they know what speaks to them. I may do a study and come up with the results but if I can’t explain the results to patients, it’s not going to have the same impact.”
In terms of learning from others and having a multi-disciplinary impact, Dr. Ahmed will be meeting regularly with the Sex and Gender Leads involved with the other Strategy for Patient-Oriented Research (SPOR) chronic disease networks to share ideas and best practices.