Estrogen Replacement Raises Kidney Stone Risk

Findings should be considered in postmenopausal ERT decision making
By Monica Smith
HealthDay Reporter

TUESDAY, Oct. 12 (HealthDay News) -- Estrogen therapy appears to significantly increase the risk of kidney stone formation in healthy postmenopausal women, according to research published Oct. 11 in the Archives of Internal Medicine.

Naim M. Maalouf, M.D., of the University of Texas Southwestern Medical Center in Dallas, and colleagues examined the incidence of nephrolithiasis in 10,739 women who had had a hysterectomy and were randomized to receive conjugated equine estrogens or placebo (average follow-up, 7.1 years) and 16,608 women who had not had a hysterectomy and were randomized to estrogen plus progestin or placebo (average follow-up, 5.6 years). The objective of the study was to determine the risk of nephrolithiasis in postmenopausal women receiving estrogen therapy.

The risk for nephrolithiasis was similar in the placebo and treatment arms at baseline, but estrogen therapy raised the risk of nephrolithiasis significantly, from 34 to 39 cases per 10,000 person-years. This increased risk was independent of coadministration of progestin.

"These data suggest that estrogen therapy increases the risk of nephrolithiasis in healthy postmenopausal women. These findings should be considered in decision making regarding postmenopausal estrogen use. The mechanisms underlying this higher susceptibility remain to be determined," the authors write.

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