☆ 4.3 Article

Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study

BMC ENDOCRINE DISORDERS (2021)

Journal

BMC ENDOCRINE DISORDERS

Volume 21, Issue 1, Pages -

Publisher

BMC

DOI: 10.1186/s12902-021-00817-3

Keywords

Endogenous estrogen exposure; Chronic kidney disease (CKD); Menopause; Menarche; Estimated glomerular filtration rate (eGFR)

Funding

Research Institute for Endocrine Sciences [1397.284]

Ask authors/readers for more resources

Protocol

Community support

Reagent

Community support

Automated Summary New
Abstract

Despite strong evidence supporting the protective role of estrogen in kidney function for women, limited data is available on the impact of endogenous estrogen exposure (EEE) on chronic kidney disease (CKD). This study found a higher risk of CKD incidence in women with low EEE levels in later life, suggesting screening for CKD in these individuals may be recommended.

Background Despite strong evidence demonstrating the role of estrogen as a protective factor for kidney function in women, limited data are available regarding the influence of endogenous estrogen exposure (EEE) on chronic kidney disease (CKD). The present study aimed to assess the incidence of CKD in women with various levels of EEE. Methods In a prospective population-based study over a 15-year follow-up, a total of 3043 eligible women aged 30-70 years, participating in Tehran-Lipid and Glucose-Study were recruited and divided into two groups (EEE < 11 and EEE >= 11 years). EEE calculated based on age at menarche, age at menopause, number and duration of pregnancies, lactation, and duration of oral contraceptive use after excluding the progesterone dominant phase of the menstrual cycle. Cox's proportional hazards model was applied to estimate the hazard ratio of CKD between the study groups, after adjusting for confounders. Results The total cumulative incidence rate of CKD was 50.1 per 1000 person years; 95% CI: 47.7-52.6); this was 53.9 (95%CI, 50.2-57.8) and 47.1 (95%CI, 44.0-50.4) per 1000 person years in women with EEE < 11 and EEE >= 11 years, respectively. The model adjusted for age, BMI, smoking, hypertension, and diabetes showed that the hazard ratio (HR) of incidence CKD in women with EEE < 11 compare to those with EEE >= 11 years in the subgroup of women aged< 45 years was 2.66(95% CI, 2.2, 3.2), whereas, in the subgroup aged >= 45 years, it was 1.22 (95% CI, 1.04, 1.4). Conclusion This study shows a higher HR of CKD incidence in women with low EEE levels in their later life. Screening of these women for CKD may be recommended.

Authors

I am an author on this paper

Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.3

Not enough ratings

Secondary Ratings

Novelty

Significance

Scientific rigor

Rate this paper

The Kidney Failure Risk Equation: Evaluation of Novel Input Variables including eGFR Estimated Using the CKD-EPI 2021 Equation in 59 Cohorts

Morgan E. Grams, Nigel J. Brunskill, Shoshana H. Ballew, Yingying Sang, Josef Coresh, Kunihiro Matsushita, Aditya Surapaneni, Samira Bell, Juan J. Carrero, Gabriel Chodick, Marie Evans, Hiddo J. L. Heerspink, Lesley A. Inker, Kunitoshi Iseki, Philip A. Kalra, H. Lester Kirchner, Brian J. Lee, Adeera Levin, Rupert W. Major, James Medcalf, Girish N. Nadkarni, David M. J. Naimark, Ana C. Ricardo, Simon Sawhney, Manish M. Sood, Natalie Staplin, Nikita Stempniewicz, Benedicte Stengel, Keiichi Sumida, Jamie P. Traynor, Jan van den Brand, Chi-Pang Wen, Mark Woodward, Jae Won Yang, Angela Yee-Moon Wang, Navdeep Tangri

Summary: The kidney failure risk equation (KFRE) accurately predicts kidney failure risk in people with GFR < 60 ml/min per 1.73 m(2) when using the CKD-EPI 2021 creatinine equation. Other modifications to the KFRE did not improve its performance.

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2023)