Oral estrogen therapy in postmenopausal women is associated with loss of kidney function
Oral estrogen therapy in postmenopausal women is associated with loss of kidney function
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DOI：
10.1038/ki.2008.205
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发表时间：
2008-08-01
影响因子：
19.6
通讯作者：
Hemmelgarn, Brenda R.
中科院分区：
文献类型：
--
作者：
Ahmed, Sofia B.;Culleton, Bruce F.;Hemmelgarn, Brenda R.
女性通常可以防止肾功能的逐渐丧失;然而，这种优势似乎随着绝经而减弱。由于使用激素治疗和肾功能之间的关系的报告相互矛盾，我们研究了5845名妇女（1459名激素治疗和4386名非使用者），这些妇女年龄超过66岁，在2年的研究期间至少有2次血清肌酐测量。校正协变量后，与非激素使用者相比，激素使用（仅雌激素、仅孕激素或两者）与估计GFR的显著损失相关，作为主要结局，沿着肾功能快速丧失的风险增加作为次要结局。这种丢失率的增加与口服雌激素有关，而与经阴道雌激素无关。雌激素累积剂量的增加也与估计的GFR的更大下降相关。我们的研究表明，在老年人群中，雌激素的使用与肾功能丧失之间存在剂量依赖性的独立关联。
Women are generally protected against progressive loss of kidney function; however, this advantage seems to diminish with menopause. Because of conflicting reports on the association between use of hormone therapy and kidney function we studied 5845 women (1459 on hormone therapy and 4386 non-users) who were over 66 years of age and had at least 2 serum creatinine measurements during the 2 year study period. After adjustment for covariates, hormone use (estrogen-only, progestin-only, or both) was associated with a significant loss of estimated GFR as the primary outcome along with an increased risk of rapid loss of kidney function as the secondary outcome compared to non-users. This increased rate of loss was associated with oral but not transvaginal estrogen use. An increased cumulative dose of estrogen was also associated with a greater decline in estimated GFR. Our study shows an independent association in a dose-dependent manner of estrogen use and loss of kidney function in this elderly population.