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174 Journal of Nephrology (2018) 31:173–184 opportunity to reflect on the importance of women’s health and specifically their kidney health, on the community, and the next generations; as well as to strive to be more curious about the unique aspects of kidney disease in women, so that we may apply those learnings more broadly. Girls and women, who make up approximately 50% of the world’s population, are important contributors to society and their families. Besides childbearing, women are essen tial in childrearing and contribute to sustaining family and community health. Women in the twenty-first century con tinue to strive for equity in business, commerce, and pro fessional endeavours, while recognizing that in many situa tions, equity does not exist. In various locations around the world, access to education and medical care is not equitable amongst men and women; women remain under-represented in many clinical research studies, thus limiting the evidence base on which to make recommendations to ensure best out comes (Fig. 1). In this editorial, we focus on what we do and do not know about women’s kidney health and kidney disease, and what we might learn in the future to improve outcomes for all. What we know and do not know Pregnancy is a unique challenge and is a major cause of acute kidney injury (AKI) in women of childbearing age; AKI and pre-eclampsia (PE) may lead to subsequent CKD, but the entity of the risk is not completely known [2–5]. CKD has a negative effect on pregnancy even at very early stages [6, 7]. The risks increase with CKD progression thus posing potentially challenging ethical issues around concep tion and maintaining of pregnancies [6–8]. We do know that PE increases the probability of hypertension and CKD in later years, but we have not evaluated a surveillance or reno protective strategy to determine if progressive loss of kidney function can be attenuated [9–12]. Specific systemic conditions like systemic lupus erythe matosus (SLE), rheumatoid arthritis (RA), and systemic scleroderma (SS), are more likely to affect women than men. We do not know the relative contribution of these acute and chronic conditions on progression to end-stage renal disease (ESRD) in women. In CKD cohorts, the prevalence in women is always less than in men, and they have slower progression to ESRD [13–15]. We do not know why and how much of this is due to differences in identification of kidney impairment, differ ent access to care, or true difference in disease severity and prevalence. Fig. 1 Sex differences throughout the continuum of CK