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Abstract
Several studies have demonstrated the nephroprotective effects of estrogen on renal damage. In light of the inconsistent results of previous findings, this study aims to evaluate the in-depth role of menopausal hormone therapy (MHT) on the development of end stage renal disease (ESRD). 3,109,506 Korean adult women who had undergone a medical examination in 2009 (index year) were initially identified for inclusion in this study. We excluded subjects had not experienced menopause naturally, had data missing for at least one variable, and were diagnosed with ESRD within 1 year from the index year. MHT data was obtained from self-reporting questionnaires and the primary outcome was the development of ESRD from the index year until December 31, 2018. A final total of 1,460,311 subjects were included in this study. The participants were divided into four groups according to the duration of MHT; no history of MHT, MHT < 2 years, 2 ≤ MHT < 5 years, MHT ≥ 5 years. During the 9-year study period, a total of 4905 participants developed ESRD. The participants who had a history of MHT use were found to have a 30% reduced risk of developing ESRD. Results from the subgroup analyses were similar to that of the primary study. The findings in this study demonstrate the beneficial effects of MHT on the development of ESRD in postmenopausal women. Based on results, our study may offer suggestions for further studies to investigate the therapeutic options on kidney disease.
Highlights
Several studies have demonstrated the nephroprotective effects of estrogen on renal damage
The study population was assigned to four groups according to the duration of menopausal hormone therapy (MHT); no history of MHT, MHT < 2 years, 2 ≤ MHT < 5 years, MHT ≥ 5 years. 84.1% (n = 1,228,203 participants) of the study population had not received MHT compared with 15.9% (n = 232,108 participants) who had
The participants who had never received MHT were more likely to have more than two offspring, a longer duration of breast feeding (≥ 12 months), and to have started menstruation at an older age
Summary
Several studies have demonstrated the nephroprotective effects of estrogen on renal damage. In light of the inconsistent results of previous findings, this study aims to evaluate the in-depth role of menopausal hormone therapy (MHT) on the development of end stage renal disease (ESRD). The findings in this study demonstrate the beneficial effects of MHT on the development of ESRD in postmenopausal women. Similar sex disparities have been reported in kidney diseases including incidence, prevalence, rate of progression, and outcomes of kidney diseases. A peak in the prevalence of end stage renal disease (ESRD) was observed in perimenopausal women, when the activity of female hormones started to d ecline[12]. This paper further investigates the beneficial effects of menopausal hormone therapy (MHT) on the development of ESRD in postmenopausal women by significantly expanding the population size through the utilization of a nationwide population-based study. Variables Age Age groups 40 ≤ age < 50 50 ≤ age < 60 Age ≥ 60 years Diabetes Hypertension Dyslipidemia CKD WC (cm) BMI (kg/m2) Obesity (BMI ≥ 25 kg/ m2) Smoking status Never smoker Ex-smoker Current smoker Alcohol consumption No Mild drink Heavy drink Physical activity
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