Abstract
Menstrual irregularity and short reproductive lifespan have been identified as cardiovascular risk factors in the general population, though the prevalence and effect of these disturbances in the high cardiovascular risk chronic kidney disease (CKD) population is unclear. We aimed to summarize the state of the science of menstrual regularity and reproductive lifespan in women with CKD and kidney failure (KF) treated with dialysis or kidney transplantation. Utilizing a peer-reviewed search strategy, electronic bibliographic databases (Medline, EMBASE, CINAHL) were searched for relevant articles published between inception and October 2020. Studies (prospective or retrospective cohort, case-control and cross-sectional) that examined menstrual regularity and/or reproductive lifespan in women with CKD or KF treated with dialysis or kidney transplantation were eligible for inclusion. Two reviewers independently completed all abstract screening, full text review, data extraction, and quality assessments using the National Institute for Health Quality Assessment for cohort studies. Results are presented descriptively, and random effects meta-analysis models will be used to derive pooled effect estimates. Database searching identified 3,527 studies in total. 157 studies were retained after abstract screening, and 52 studies were deemed eligible for inclusion after full-text review. Reviewer agreement through the abstract screen and full text review was 90.4% and 76.5%, respectively. Data-extraction and analysis is ongoing. Preliminary results indicate a large proportion of women with CKD experience menstrual irregularity and short reproductive lifespan that is more pronounced in the later stages of CKD and those with KF. It is unclear whether menstrual regularity is improved after treatment with kidney transplantation. This systematic review and meta-analysis will provide an important overview of the prevalence and effect of menstrual regularity and reproductive lifespan in people with CKD and KF. Given the high cardiovascular risk of the CKD population, description and analysis of these novel sex-specific cardiovascular risk factors will inform care of this understudied population.
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