Studies in the general population and individuals with chronic kidney disease (CKD) show that men experience greater declines in kidney function with age and progress to end-stage kidney disease (ESKD) faster than women.1 Observational human and experimental studies implicate that estrogens may confer kidney protection through endothelial-related, anti-fibrotic and/ or anti-apoptotic mechanisms.1 Conversely, testosterone may have deleterious kidney effects by promoting apoptosis, inflammation and fibrosis.