Showing posts sorted by date for query SUGAR. Sort by relevance Show all posts

Monday, September 21, 2026

Germany: The Left triumphs in Berlin as AfD surges in Mecklenburg-Western Pomerania

By Johanna Urbancik

Published on 21/09/2026 - EURONEWS

Germany’s final state elections of the year have delivered a sharp political shake-up. The Left has won Berlin, while the AfD has come out on top in Mecklenburg-Western Pomerania, with the CDU suffering heavy losses in both elections.

Germany's final state elections of the year have redrawn the political map, with the Left emerging as the strongest force in Berlin and the AfD taking the lead in Mecklenburg-Western Pomerania. The CDU suffered heavy losses in both states, while the SPD made significant gains under state premier Manuela Schwesig.

In Berlin, the latest Infratest dimap projection puts the Left at 25.7% of the vote. The CDU comes second with 18.8%, followed by the AfD at 16.3% and the Greens at 14.3%. The SPD has fallen further behind to 12.1%, while the BSW narrowly clears the threshold for parliament.

The result means the capital's previous CDU-SPD coalition no longer has a majority. In Mecklenburg-Western Pomerania, the AfD leads with 38.2%, closely followed by the SPD at 35.5. The CDU records its worst result in the state's history with just 4.9%, while the Left, Greens and BSW all remain around or just above the threshold for entering parliament.

Merz: Mecklenburg-Western Pomerania result is a 'disaster'

Chancellor Friedrich Merz said there was no way to "sugar-coat" the CDU's result in Mecklenburg-Western Pomerania. "It is a disaster," the CDU leader said in a statement at the party's headquarters in Berlin. He said his party had been "squeezed out" as the contest narrowed to a battle between the SPD and AfD.

Should the CDU stay below 5% in the final vote count, it would mean that the party would fail for the first time to win seats in a state legislature anywhere in Germany.

In Berlin, by contrast, CDU lead candidate Stefan Evers had secured a "respectable result" despite a difficult starting position, Merz said.

German Chancellor Friedrich Merz speaks to media at the Christian Democratic Union party headquarters in Berlin, Germany, Sunday, Sept. 20, 2026. AP Photo/Markus Schreiber

Merz then turned to the wider situation in Germany. He said the country had become too complicated and that its economy was facing a period of profound change. Public debate was becoming increasingly heated, while trust in institutions was declining, Merz said. He called for further reforms, arguing that the disruption they would bring – and the fact that they would not be universally popular – would have to be accepted.

He ended by warning of the "authoritarian poison" that he said was increasingly finding its way into society through the "fascination with authoritarianism". As CDU leader and chancellor, he said he wanted to take responsibility. Germany, he said, must once again become a "country of new beginnings".

AfD leads in Mecklenburg-Western Pomerania, as Schwesig could remain in office

Following the election result in Mecklenburg-Western Pomerania, AfD lead candidate Leif-Erik Holm claimed the right to form the next state government. He said the party would "naturally also talk to all the other parties" in an effort "to get things moving". "It's about the people of our state. We want to improve politics," Holm told German public broadcaster ARD.

Asked about possible cooperation with other parties, Holm pointed out that the AfD in Mecklenburg-Western Pomerania is not being monitored by the Federal Office for the Protection of the Constitution. He said the party had a "conservative programme" covering education, the economy and security.

Leif-Erik Holm, the AfD's candidate for minister-president in Mecklenburg-Western Pomerania, in Schwein, Germany, Sunday, Sept. 20, 2026. Jens Büttner/dpa via AP

Manuela Schwesig, the SPD's state premier in Mecklenburg-Western Pomerania, could therefore stay on despite the AfD coming out ahead. During her campaign, she put herself at the centre of the SPD's campaign with the slogan "Woman against Blue", a play on the AfD's party colour.

Speaking to ZDF, Schwesig described it as the "toughest state election" her party had ever faced. In an interview, she said the SPD had stood up to the AfD "with substance, with people, with clarity and with a united effort". Schwesig's political record also includes her past support for Nord Stream 2.

In 2021, her state government set up the Foundation for Climate and Environmental Protection MV, which backed the construction of the pipeline. After Russia invaded Ukraine, Schwesig acknowledged that her position at the time had been a mistake. During a visit to Kyiv in 2024, she said that "Ukraine must win this war" and backed further arms deliveries.

Berlin's 'Mamdani effect'

Berlin’s Left party made social issues and affordable housing key themes of its election campaign, with lead candidate Elif Eralp also looking to New York. After left-wing Democrat Zohran Mamdani won the New York mayoral election, she told the German Press Agency (dpa): "If a left-wing candidate can win in New York, then there's no reason it can't happen in Berlin."

The Left has now emerged as the strongest party in Berlin for the first time. If Eralp becomes governing mayor, she would be the first mayor of Berlin from a migrant background. Her parents fled Turkey for Germany in 1980, while Eralp was born in Munich.

The housing crisis was at the heart of Eralp's campaign. She called for tighter regulation of rents, more social housing and further moves towards bringing large housing portfolios into public ownership.

The Left is the successor to the former East German ruling party, the SED (Socialist Unity Party of Germany). After the fall of the Berlin Wall, the SED initially rebranded itself as the PDS (Party of Democratic Socialism), retaining some of its assets and personnel. It later became known as the Left.

The election victory now leaves the party facing a difficult task in forming a government. The SPD and Greens have not ruled out working with the Left, but both have made clear that any cooperation would depend on how the party deals with antisemitism. SPD lead candidate Steffen Krach said before the election at an event organised by Berlin's Jewish community: "If there are antisemitic incidents, then it's over. Simple as that."

The issue was brought into focus by an appearance by rapper Dahabflex at a Left campaign event in Berlin's Neukölln borough. Chants including "Death to the IDF" and "Yalla Yalla Intifada" were heard at the event.

Eralp distanced herself from the remarks and called for an investigation and consequences. The Greens have also set out a clear condition. Lead candidate Werner Graf said his party would not sign a coalition agreement that did not take a clear stance against antisemitism.

Eralp, for her part, stressed that the overwhelming majority of the Left stood for protecting Jewish life. She said antisemitism was a problem across society and also existed within the Left. She said she wanted to protect Jewish, Palestinian and Muslim communities.

Sunday, September 20, 2026

Projections: Merz's conservatives set to crash out of state parliament

20.09.2026

Photo: Bernd von Jutrczenka/dpa

German Chancellor Friedrich Merz's conservative Christian Democrats (CDU) are on the brink of crashing out of the parliament in the north-eastern state of Mecklenburg-Vorpommern after latest projections showed the party falling under the 5% threshold needed to win seats.

Broadcasters ZDF and ARD both projected the CDU to win 4.9%, down from 13.3% in the last election in 2021. The result would be a nightmare scenario for Merz, whose political future has been the source of intense speculation as his approval ratings have plummeted in recent months.

Long the largest party in post-war Germany, the CDU has never previously failed to hit the 5% threshold in any state, European or federal election. Its record low of 9% was set in Bremen in 1951.

Even with initial projections showing the party above the 5% mark, Merz called the situation in Mecklenburg-Vorpommern a "disaster," while continuing to insist on the need to implement his government's unpopular reform agenda.

But falling out of the state parliament would represent a massive shock for the chancellor's party, raising fresh doubts over Merz's position after the debacle in nearby Saxony-Anhalt two weeks ago.

Sunday's election was won by the far-right Alternative for Germany (AfD) on around 38% of the vote, narrowly ahead of the centre-left Social Democrats (SPD) on 35.5%.

The CDU was not the only party hanging close to the 5% threshold: the populist Sahra Wagenknecht Alliance (BSW) was also on 4.9% in the latest projections, while the Greens were on around 5.5%.

The Left - which also defeated the CDU to win the state election in Berlin on Sunday - was on 6.5% according to the latest projections.

German far-right AfD wins second state election in major blow to Merz

21.09.2026, DPA

Photo: Michael Kappeler/dpa

The far-right Alternative for Germany (AfD) won the state election in Mecklenburg-Vorpommern, its second state victory in just two weeks, while German Chancellor Friedrich Merz's conservative party suffered its worst-ever showing in its 81-year history, according to preliminary results.

Merz's Christian Democrats (CDU) crashed out of the parliament in the north-eastern state with just 4.9% of the vote, down from 13.3% in the last election in 2021 and just short of the 5% threshold required to win seats.

The AfD earned around 38.2% of the vote, ahead of the centre-left Social Democrats (SPD) on 35.5%, according to the election commission.

The populist Sahra Wagenknecht Alliance (BSW) also missed parliament, with 4.8%, while the Greens garnered 5.7% of the vote.

The Left - which also defeated the CDU to win the state election in Berlin on Sunday - was on 6.5%.

The result is a nightmare scenario for Merz, whose political future has been the source of intense speculation as his approval ratings have plummeted in recent months.

Long the largest party in post-war Germany, the CDU has never previously failed to hit the 5% threshold in any state, European or federal election. Its previous record low of 9% was set in Bremen in 1951.

Merz admitted the result was a "disaster" but insisted he would push forward with his government's unpopular economic and social reform package, signalling he does not intend to resign.

He conceded that it was not possible to "sugar-coat" Sunday's result, but vowed "to prepare our country for the future."

"What needs to be done now requires backbone, steadfastness and patience. I will muster these qualities - as chairman of the CDU and, above all, as chancellor of our country."

Leif-Erik Holm, the AfD's candidate for state premier, hailed a "wonderful evening" on election night, saying his party would offer to hold talks with all other factions.

Tense Berlin election finale: who is to emerge strongest in the capital?

By Johanna Urbancik

Published on 19/09/2026 - EURONEWS

The Left and the CDU are vying for first place, with the AfD and the Greens trailing and the SPD suffering heavy losses. An overview of parties, leading candidates, key issues and possible coalitions.

On Sunday, Berliners will vote to elect a new state parliament, the Abgeordnetenhaus, alongside the regional vote in Mecklenburg-Western Pomerania. The race is wide open: the Left party and the CDU are neck and neck in the latest polls, both at around 20-23%, with the AfD at 18% and the Greens at 16% close behind. The SPD, with 10-12%, is now clearly below its 2023 result.

That means it is also unclear what the political landscape will look like after the vote.

According to recent surveys, the current black-red coalition of the CDU and SPD would no longer have a majority. The CDU’s campaign has also shifted: instead of incumbent Governing Mayor Kai Wegner, finance and culture senator Stefan Evers is running as lead candidate. Wegner announced in the summer, after months of criticism of his handling of the January power outage, that he would not run again as the party’s frontrunner.

On policy, the CDU is focusing on law and order, a more capable state and economic growth. To that end, both the police and the judiciary are to be strengthened, approval procedures accelerated, and public administration digitised.

Based on current polls, several coalition options are on the table, including a government of the Left, Greens, and SPD, or a CDU-Green-SPD alliance. Whether such constellations materialise will also depend on which parties ultimately make it into the Abgeordnetenhaus.

In the latest ZDF projection (source in German) published on 11 September, the Left stands at 23%, the CDU at 21%, the AfD at 17%, the Greens at 16%, and the SPD at 10%. On that basis, both a Left-Green-SPD alliance and a CDU-Green-SPD coalition would have a numerical majority. The current BerlinTREND (source in German) survey by Infratest dimap paints a similar picture: the Left at 21%, CDU at 20%, AfD at 18%, Greens at 16%, and SPD at 12%.

SPD fighting to stay in government

The Social Democrats have now slipped to between 10 and 12% in the polls. In 2023, they were still at 18.4%. Their lead candidate is Berlin SPD co-chair Steffen Krach from Lower Saxony, who is under investigation by the Hanover public prosecutor over allegations linked to a donation of 9,900 euros to the Berlin SPD. Krach rejects the accusations and is continuing his campaign under the slogan "Wieder Berlin" – "Berlin again" – despite them.

Substantively, the SPD, like most other parties, is focusing on affordable housing, investment and a functioning infrastructure. In its manifesto, it promises 100,000 new homes over the next legislative period and aims to increase the share of social housing in new-build projects from 30% to 50%. It also plans to invest in roads and bridges, schools, hospitals, and public transport.

Affordable housing is also a central campaign issue for the other parties. According to Berlin’s Senate Department for Urban Development, Building and Housing, more than 100,000 new homes are missing in the capital. On top of that comes demand for additional housing for the roughly 200,000 people expected to move to Berlin by 2040. This translates into an average need for around 20,000 new homes per year in the coming years.

The CDU is relying above all on faster construction and more homeownership. The Greens place greater emphasis on housing oriented towards the common good. The Left, by contrast, is calling for large housing portfolios to be brought into public ownership. The AfD and FDP reject this approach and likewise want to prioritise private construction and less regulation.

The Left eyes the Red Town Hall

The Left has gained significant support since the 2023 election. At the time, it stood at 12.2%; in current polls, it is around 21-23% and is now one of the two strongest parties in the race.

Lead candidate Elif Eralp is campaigning primarily on rents and social policy. The Left is calling, among other things, for the socialisation of large housing stocks and stronger tenant protections. In public transport, social benefits and climate policy, the party also wants the state to play a bigger role.

Campaign poster of the Left’s lead candidate, Elif Eralp Euronews

The Berlin Left’s campaign is, however, overshadowed by a debate over how the party deals with antisemitism and the Middle East conflict. One trigger was a performance by rapper Dahabflex at a campaign event organised by the Neukölln district branch of the Left at the end of August, where he chanted "Yalla Yalla Intifada, Westbank, Palestine, Gaza" and "Death to the IDF" (death to the Israeli armed forces).

CDU lead candidate Evers accused Eralp of not acting decisively enough against antisemitic tendencies in her party. Eralp rejects that and stresses her commitment to combating antisemitism and protecting Jewish life. The Berlin Left has also adopted its own guidelines on dealing with antisemitism and says it wants to protect Jewish life in the city. As T-Online reports, the party’s Berlin executive invited the Neukölln district spokespeople to an extraordinary meeting at which "a unanimous decision was taken that Dahabflex’s performance was a mistake and that we reject all forms of violence", according to Eralp.

AfD also on course to double its vote in Berlin?

The AfD has also made strong gains in Berlin. In the 2023 repeat election, it took 9.1%; it now stands at 17-18% in most polls. In the latest BerlinTREND survey by Infratest dimap, it reached 18%, making it the third-strongest force behind the Left and the CDU. Compared with 2023, it has almost doubled its share of the vote.

AfD lead candidate Kristin Brinker Euronews

The party is once again led by Kristin Brinker, who is running as the AfD's top candidate for the third time. As with the Greens, however, Brinker is not widely known. In the current Infratest dimap poll (source in German), around two-thirds of respondents say they do not know Brinker, or do not know her well enough to judge her. The picture is similar to the Greens’ Werner Graf.

In the campaign, the AfD is focusing above all on migration and internal security. The party wants a halt to the admission of asylum seekers in Berlin and the "immediate deportation of all of the up to 20,000 people in Berlin who are required to leave the country".

For subsidised and state-owned housing, the AfD wants to allocate it using a points system so that it primarily benefits Berliners who have lived in the city for a long time and work in "system-relevant professions" such as the police, fire service, health care, or refuse collection. Otherwise, building should be encouraged by scrapping the property transfer tax or speeding up planning approvals.

Despite its high poll ratings, the party remains excluded from any role in government: CDU, SPD, Greens and Left all rule out forming a coalition with the AfD.

Will the Greens be the kingmakers?

The Greens are currently polling at around 16

5, clearly below their 2023 result of 18.4%. Nevertheless, they could play a crucial role in forming a government: both a Left-Green-SPD alliance and a CDU-Green-SPD coalition would have a mathematical majority in current projections.

Lead candidate Werner Graf is trying to present the Greens in a less confrontational way during the campaign. He wants to avoid the major rows of recent years, such as the dispute over Friedrichstrasse. Graf himself told rbb that the Greens "have learned from that". Instead of sharply polarising demands, he is adopting a more pragmatic tone and presenting himself as someone who can bring different parties together.

In the election arena, shortly before polling day, both the Left's lead candidate, Eralp, and the SPD frontrunner, Krach, explicitly courted cooperation with the Greens. Graf signalled openness to an alliance and called for a "progressive government". He rules out any cooperation with the AfD.

Volt, FDP and BSW battling to enter parliament

Alongside the larger parties, Volt, the FDP and the BSW are also competing to enter the Abgeordnetenhaus. For all three, the five% threshold is the decisive hurdle. Volt is standing in a Berlin Abgeordnetenhaus election for the first time and is focusing above all on digitalisation, administrative reform and faster housing construction.

The FDP wants to return to the state parliament with its lead candidate, Christoph Meyer, and is campaigning for less regulation, more private investment, and homeownership. In the final stretch, Meyer is also backed by party chairman Wolfgang Kubicki, who has appeared with him in Berlin on several occasions.

Campaign posters for BSW, Volt and the FDP in Berlin Euronews

The Sahra Wagenknecht Alliance (BSW) is polling at 3-4% and therefore has to fight to clear the threshold for the Abgeordnetenhaus. The party is running in a Berlin Abgeordnetenhaus election for the first time and is led by Alexander King and Michael Lüders.

In this campaign, foreign and peace policies are playing an unusually prominent role for a state election. King is calling for an end to sanctions against Russia and for negotiations with Moscow. BSW also wants to improve relations with Russia and is targeting Russian-speaking Berliners. The party, moreover, wants to prevent the Russian House on Friedrichstrasse, operated by Russia, from being closed.

Vandalism: campaign posters damaged

During the current election campaign in Berlin, the police have recorded more than 1,300 incidents of damaged campaign posters between 2 August and 16 September.

Election posters in Berlin: AfD posters particularly often affected by vandalism Euronews

Posters belonging to the AfD are particularly frequently affected, according to Bild, which asked the Berlin police for figures: across the city, 801 cases of criminal damage to AfD posters have been recorded so far. Next come the CDU with 148 cases, independent candidates or lists with 102, the Left with 95, the SPD with 88, Alliance 90/The Greens with 37, the FDP with 30, BSW with 16, Volt with 13 and the ÖDP with two cases.

INTERVIEW

As far right gains ground in Germany, Berlin election tests Europe's centre

Berliners go to the polls on Sunday to elect the city-state’s parliament and district councils, in a vote taking place just two weeks after the far-right Alternative for Germany (AfD) secured a historic victory in the eastern state of Saxony-Anhalt. The implications could extend beyond Germany.

Issued on: 19/09/2026 - RFI

An election poster for the far-right, anti-immigration party Alternative for Germany (AfD), reading "It's time for free opinion", in Magdeburg, 7 February 2025. © Ebrahim Noroozi / AP

By: Jan van der Made

The AfD won 43.8 percent of the vote in Saxony-Anhalt on 6 September, falling three seats short of an absolute majority in the state parliament.

The result has intensified debate about the strength of the democratic centre in Germany and beyond.

The AfD has received support from figures associated with United States President Donald Trump, including alt-right billionaire Elon Musk, while also positioning itself alongside Hungary’s former leader Viktor Orban and Russian President Vladimir Putin.

In France, Marine Le Pen is leading in polling ahead of the 2027 presidential election, with recent surveys giving her between 29 and 36 percent in the first round.

Against this backdrop, what does the AfD’s breakthrough mean for Germany, Europe and the future of the political right?

RFI spoke to Bernd Hüttemann, secretary-general of the German chapter of the European Movement, a non-partisan civil society organisation that promotes European integration.

Bernd Hüttemann, secretary-general of the European Movement Germany, interviewed in Paris, 12 September 2026. © RFI/Jan van der Made

RFI: Berlin’s elections are taking place shortly after the AfD’s historic victory in Saxony-Anhalt. What does that result mean for German politics?

Bernd Hüttemann: It is something very dark, because it has really started a new era in Germany. For the first time, there is a right-wing extremist party that could potentially take power at state level.

Saxony-Anhalt is a small state, but the Länder [federal states] are powerful in Germany. They are responsible for areas such as education, policing, security and a large part of public administration. So the result will change things at that level.

It will not necessarily change the balance of power at federal level, because Saxony-Anhalt has relatively few votes in the Bundesrat [upper house of the German parliament]. But if the democratic majority becomes nervous and starts following extremist ideas, that can become very dangerous.

AfD candidate Ulrich Siegmund speaks in front of a poster reading "It starts here" at a rally after the Saxony-Anhalt regional elections in Magdeburg, eastern Germany, 6 September 2026. @ AP Photo/Matthias Schrader

Merz ‘deeply shocked’ as far-right victory tests Germany’s political firewall

RFI: If you look at the map of the 2025 election results, it appears that AfD is most popular in former East Germany. How do you explain people who lived under an authoritarian communist system now voting for an extreme-right party?

BH: There was always an East-West divide. As a young West German in the 1980s, I saw a great deal of propaganda saying that East Germans were different from us. They were portrayed as living under a very bad social system and an undemocratic regime.

After the Berlin Wall came down, the divide became more complicated. Around one-third of East Germans moved to the West, particularly young people, women, skilled workers and liberal-minded citizens.

At the same time, many West Germans moved east and took senior positions. Judges, professors and many other professionals came from the West. It is not pleasant for people in the east to feel that there is a ruling class imposed from outside.

East German workers build up a section of the Berlin wall, on 15 August 1961. @ AFP

That does not mean that all of these voters are anti-democratic. But many people have little experience of taking social responsibility outside the state. They do not want to join political parties or associations. They simply want an easier life, especially after the hardship they experienced before the Wall fell.

So this is not only about an East-West divide. It is about whether authoritarian ideas can find fertile ground. That is certainly more likely in eastern Germany.

RFI: Do you believe Germany’s political diversity can act as a safeguard?

BH: Yes. Germany is a very diverse country. It contains Catholic, Protestant, atheist, Muslim and East German traditions, among many others. Its political system is also complex: it is federal, decentralised and based on cooperation with many social forces.

That makes Germany complicated and slow, but it also makes it more resilient. I would not be excessively concerned. The important thing now is for democratic movements and parties to stay together.

Map of the 2025 German election results, with the Christian Democrats (CDU, in grey) dominating in former West Germany and the Alternative for Germany (AfD, shown in blue) dominating in what was communist East Germany. © Image generated via Perplexity

RFI: How much influence do Trump-style populist politics and US-based propaganda have on the AfD and German politics more broadly?

BH: The AfD has a problem here. Particularly in eastern Germany, there is not a strong appetite for American influence. On the other hand, the party has very few friends. It has Vladimir Putin. Viktor Orban congratulated the party. There are links with MAGA supporters and with Elon Musk.

The party’s psychology is perhaps this: nobody likes us, the public rejects us and everybody is trying to exclude us. So we align ourselves with people who are even more extreme.

But it could backfire. People in western Germany, as well as many liberals in the east, do not necessarily like this association.

US billionaire Elon Musk attends the AfD's election campaign kickoff in Halle via video link, on 25 January 2025. @ AP - Sebastian Willnow

RFI: Marine Le Pen is leading polls ahead of France’s 2027 presidential election. Could the AfD’s breakthrough influence the discourse here?

BH: The fear of Germany that existed during my childhood is not as widespread as it once was. But now there is a kind of flashback. People are asking: Germany was one of the most liberal countries in Europe in recent decades, including on issues such as refugees. Is it now showing its ugly face again?

That may also explain Marine Le Pen’s efforts to distance herself strategically from the AfD in the European Parliament. There was a well-known meeting in Paris with Alice Weidel, the AfD leader, where Weidel reportedly entered through a back door to avoid being photographed with Le Pen.

If France, a proud nation, moves towards the right, it will want to draw a clear line between itself and German extremism.

But that is not good for Europe, because we do not need a return to nationalism. We do not need national answers to nationalist movements in Germany. We need European answers – particularly when it comes to war, China and the United States. Europe has to remain united, and it is also developing closer links with Canada.

Friday, September 18, 2026

Women’s kidney health may be overlooked, delaying critical prevention and treatment opportunities

A new American Heart Association scientific statement encourages equitable access to kidney care, sex-specific research analyses and more to improve women’s kidney health

American Heart Association

Statement Highlights:

Diagnosis of women’s chronic kidney disease (CKD) is often delayed, and they are less likely to begin dialysis or receive a kidney transplant.
Several female-specific factors impact women’s kidney and cardiovascular health throughout their lifespan, including menstrual health, pregnancy/postpartum and autoimmune disease along with social and cultural factors.
Women remain underrepresented in clinical trials for CKD.
The statement suggests advancing kidney health for women by including reproductive health assessment in CKD care, increasing women’s enrollment in clinical trials, sex-specific analysis of study findings and further study of how female biology and life stages affect kidney function and the effect of CKD treatments.

Embargoed until 4 a.m. CT / 5 a.m. ET Thursday, Sept. 17, 2026

DALLAS, Sept. 17, 2026 — Chronic kidney disease (CKD) affects about 1 in 10 women worldwide, yet diagnosis is often delayed and women are less likely to receive critical treatments like dialysis or a kidney transplant compared to men, according to a new American Heart Association scientific statement published today in the Association’s flagship journal Circulation.

The statement suggests improving women’s kidney care by recognizing how women’s unique biology and social factors affect kidney health and designing research that includes sex-specific analyses of kidney function and CKD medications.

“Many cases go undiagnosed in women because common tests and research do not always reflect women’s biology and life stages,” said Eman Y. Gohar, Ph.D., M.S., FAHA, the volunteer chair of the scientific statement writing group.

“Biological differences include genetics, sex chromosomes, hormones, immune-system responses and differences in how the body processes and responds to medication,” Gohar said. “We also need to acknowledge female-specific factors that do not apply in the same way to male patients. These include menstrual health, pregnancy, postpartum changes and menopause as well as socioeconomic factors like financial barriers or cultural expectations. Each of these creates considerations that are unique to women and may require tailored care.”

The scientific statement, “Women’s Kidney Health in Focus,” lists seven challenges women face in kidney care:

Underrepresentation in clinical trials
Less treatment access
Delayed referrals
Adverse pregnancy outcomes
Menopause
More adverse effects of kidney treatment medication
Lower rates of kidney transplant

Medication effects and underrepresentation in clinical trials

According to the statement, women may have different responses to kidney treatment medication compared to men but continue to remain underrepresented in clinical trials.

“Women are not simply smaller versions of men,” said Gohar, an assistant professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee. “Their biology, reproductive life stages and responses to medication may differ, and those differences need to be reflected in clinical care and research.”

Women and men may respond differently to medications because of differences in how they are absorbed, distributed, broken down and removed from the body. In fact, laboratory research points to estrogen receptors as having a potential role in women’s kidney function.

Kidney disease may be underrecognized in women, causing delayed referrals for care

Kidney function is commonly estimated using creatinine, a waste product generated by muscle. Because women typically have less muscle mass and may produce less creatinine, these estimates may not always accurately reflect kidney function, thus causing kidney disease in some women to be misclassified or recognized later.

Understanding aspects of kidney health that are unique to women’s life stages is critical for advancing precision medicine.

Kidney and reproductive health are closely connected

“Kidney health and reproductive health are intertwined,” Gohar said. “Pregnancy, menstrual health and menopause may provide important information about a woman’s current and future kidney health.”

Pregnancy in women with CKD may increase the risk of kidney disease progression and pregnancy complications. Taking steps to manage blood pressure, blood sugar and body weight is suggested for women with CKD who plan to become pregnant.

In women without CKD, pregnancy complications such as preeclampsia may signal an increased risk of future kidney disease, heart disease and stroke.

Natural menopause before age 45 and surgical removal of the ovaries before age 50 are each linked with a higher risk of CKD. Other factors contributing to CKD after menopause include increases in obesity, type 2 diabetes and high cholesterol.

The statement suggests that embedding reproductive health assessment in CKD care is one step towards advancing precision kidney medicine.

In addition to pregnancy and menopause, other women-specific conditions affect CKD risk. Polycystic ovary syndrome, a common hormone disorder among women, and the autoimmune disease lupus, which is more common in women than men, are linked with a higher risk of CKD.

Women face gaps in access to timely kidney care and kidney transplants

Women tend to begin dialysis at a lower level of kidney function compared to men, indicating a delay in treatment initiation. They are also less likely to receive a kidney transplant. Globally, men receive kidney transplants about 30% more often than women. In some low- and middle-income countries, the gap is more than 10-to-1.

Poverty, limited health literacy, caregiving responsibilities, cultural expectations, limited support and treatment costs may delay diagnosis or make specialist care harder to reach. These barriers may be especially serious in low-resource environments where access to kidney specialists, dialysis or transplant care is limited.

Kidney disease is part of the cardiovascular-kidney-metabolic syndrome

CKD is a major contributor to heart disease and stroke risk, which is why it is part of cardiovascular-kidney-metabolic (CKM) syndrome.

Diabetes, another part of CKM syndrome, is the leading cause of CKD worldwide. Among people with diabetes, some evidence suggests women may progress to kidney failure at higher rates than men.

Opportunities to improve kidney care for women

The statement identifies research priorities that include enrolling enough women in clinical trials to determine whether treatments affect women and men differently, reporting results by sex and reproductive health-specific factors. Future research may help health care professionals detect kidney disease earlier and choose safer, more effective treatments.

This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’s Kidney in Cardiovascular Disease Committee of the Council on the Kidney in Cardiovascular Disease; Council on Clinical Cardiology; and Council on Lifestyle and Cardiometabolic Health. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

Co-authors are Vice-Chair Silvi Shah, M.D., M.S.; Ester S. Oh, Ph.D., M.S.; Sofia B. Ahmed, M.D., MMSc; S. Ananth Karumanchi, M.D.; Roy Mathew, M.D.; Sayna Norouzi, M.D.; Giorgina Piccoli, M.D.; Jane Reckelhoff, Ph.D., FAHA; Amanda Vinson, M.D.; Licy L. Yanes Cardozo, M.D. Authors’ disclosures are listed in the manuscript.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources from the American Heart Association:

Available multimedia is on right column of release link
After Sept. 17, 2026, view the manuscript online.
Follow American Heart Association/American Stroke Association news on X @HeartNews
Follow the American Heart Association’s Circulation journal on X @CircAHA

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

Journal

Circulation

DOI

10.1161/CIR.0000000000001471

Article Title

Women’s Kidney Health in Focus: A Scientific Statement From the American Heart Association

Article Publication Date

17-Sep-2026

Media Alert: ACC Latin America 2026 studies highlight gaps in heart attack care for women across the region

American College of Cardiology

The ACC Latin America 2026 conference will feature four studies that explore sex-based and regional disparities in ST-segment elevation myocardial infarction (STEMI) management and outcomes across Latin America, focusing on women as a higher risk, yet underrepresented, patient group. The researchers use overlapping STEMI data that pulls from across Latin America, including the Caribbean, Central America, Mexico and South America. STEMI is the most serious type of heart attack.

Among the key findings of the studies, the researchers found that women with STEMI experienced worse clinical outcomes than men and had a higher risk of hypertension, diabetes, obesity, chronic kidney disease and past stroke. The research showed that women are significantly underrepresented among STEMI patients in Latin America, making up only 21% of patients in a shared cohort of 5,766. Cardiometabolic risk was heightened based on the geographic region, with the patients in the Caribbean maintaining the highest risk. The researchers recommend implementing region-specific prevention strategies across this expansive cohort.

The four studies are:

Management and Outcomes of STEMI in Latin America: A Sex-Based Analysis
Sociodemographic and Clinical Phenotypes of Women with STEMI in Latin America
Women with STEMI in Latin America: A High-Risk Phenotype with Regional Disparities
Sex Disparities Among Young STEMI Patients Across Latin America

Learn more about the meeting and see the full agenda here.

Members of the media are eligible for press registration for ACC Latin America 2026. Media registrants will be required to provide appropriate documentation and/or media credentials as per the ACC Media and Communications policies.

To register as media or for embargoed copies of manuscripts or abstracts, contact Katie Glenn at kglenn@acc.org.

The American College of Cardiology (ACC) is the global leader in transforming cardiovascular care and improving heart health for all. As the preeminent source of professional medical education for the entire cardiovascular care team since 1949, ACC credentials cardiovascular professionals in over 140 countries who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. Through its world-renowned family of JACC Journals, NCDR registries, ACC Accreditation Services, global network of Member Sections, CardioSmart patient resources and more, the College is committed to ensuring a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org or follow @ACCinTouch.

###

LA REVUE GAUCHE - Left Comment