We hypothesized that patients with CKD would have dysfunctional 11-oxygenated androgen biosynthesis as a consequence of impaired renal HSD11B2 activity, leading to inefficient conversion of 11OHA4 to 11KA4, the substrate for AKR1C3-mediated 11-oxygenated androgen activation. This evidence concerns the gene HSD11B2 and chronic kidney disease.