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NDT Advance Access published online on July 2, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp321
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Post-menopausal hormone use and albuminuria

Emily L. Schopick1, Naomi D. Fisher2, Julie Lin1, John P. Forman1 and Gary C. Curhan1,3

1 Renal Division and Channing Laboratory 2 Division of Endocrinology and Hypertension, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School 3 Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

Correspondence and offprint requests to: Emily L. Schopick; E-mail: eschopick{at}partners.org



  Abstract

Background. Higher levels of urinary albumin excretion predict future hypertension and chronic kidney disease. Post-menopausal hormone use may influence the renin–angiotensin system and renal endothelial function, impacting albumin excretion. The association between post-menopausal hormone use and albuminuria is not well defined.

Methods. We explored the cross-sectional association between duration of PMH use and albuminuria in 2445 post-menopausal, non-diabetic women from the Nurses’ Health Study. Women were categorized as hormone non-users, past users or current users grouped by 3-year intervals of duration of use, from ≤3 years to >15 years. The outcome was the top decile of urine albumin/creatinine ratio (ACR). Multivariate logistic regression was used to assess the association between duration of PMH use and risk of being in the top decile.

Results. The mean age was 66.8 years, and 57% were currently using PMH. The median ACR was 2.9 mg/g, and the 90th percentile was 9.2 mg/g. Compared with women with no history of PMH use, the odds ratio for being in the top ACR decile was lower for women with use of >6–9 years, >9–12 years, >12–15 years and >15 years, but there was no dose–response. The overall odds ratio was 0.55 (95% CI: 0.39–0.77) among women with >6 years of current PMH use compared with non-users. Current hormone use of shorter duration and past hormone use were not associated with albumin excretion.

Conclusions. Current PMH use of >6 years is associated with a lower urinary ACR in non-diabetic women.

Keywords: albuminuria; epidemiology; post-menopausal hormones

Received for publication: 18. 2.09
Accepted in revised form: 8. 6.09


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