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

• Published in: BMC endocrine disorders Vol. 21; no. 1; p. 155
• Main Authors: Farahmand, Maryam, Ramezani Tehrani, Fahimeh, Khalili, Davood, Cheraghi, Leila, Azizi, Fereidoun
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.08.2021; BioMed Central; BMC
• Subjects: Adult; Age; Aged; Analysis; Blood pressure; Body mass index; Breastfeeding & lactation; Chronic kidney disease (CKD); Chronic kidney failure; Cohort analysis; Creatinine; Diabetes; Diabetes mellitus; Endogenous estrogen exposure; Estimated glomerular filtration rate (eGFR); Estrogen; Estrogens; Estrogens - adverse effects; Female; Follow-Up Studies; Glomerular Filtration Rate; Glucose; Hormones; Humans; Hypertension; Incidence; Iran - epidemiology; Kidney diseases; Lactation; Menarche; Menopause; Menstrual cycle; Menstruation; Metabolism; Middle Aged; Oral contraceptives; Phenols; Population studies; Progesterone; Prognosis; Prospective Studies; Renal Insufficiency, Chronic - chemically induced; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - pathology; Risk Factors; Time Factors; Womens health; Iran; Menarche; Estimated glomerular filtration rate (eGFR); Endogenous estrogen exposure; Chronic kidney disease (CKD); Menopause
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-021-00817-3

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. 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. 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). 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.