Hormone therapy and urine protein excretion

A multiracial cohort study, systematic review, and meta-analysis

Andrea G. Kattah, Maria L.G. Suarez, Natasa Milic, Kejal M Kantarci, Burcu Zeydan, Thomas Mosley, Stephen T Turner, Erin B. Ware, Sharon L.R. Kardia, Vesna D Garovic

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Objective: Experimental models suggest estrogen has a renoprotective effect, but human studies show variable results. Our objective was to study the association of hormone therapy (HT) and albuminuria in postmenopausal women and to synthesize the results with outcomes from prior studies. Methods: We analyzed data from postmenopausal women who participated in the second study visit (2000- 2004) of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. The exposure was self-reported HT use and the outcome was albuminuria (urine albumin-to-creatinine ratio >25 mg/g Cr). We also conducted a systematic review and meta-analysis on the association of HT and urine protein in postmenopausal women. Continuous and dichotomous measures of protein excretion were converted to a standardized mean difference (SMD) for each study. Results: In the GENOA cohort (n = 2,217), there were fewer women with albuminuria among HT users than nonusers (9% vs 19%, P < 0.001). HT use was associated with decreased odds of albuminuria (odds ratio 0.65, 95% confidence interval (CI), 0.45-0.95), after adjusting for significant differences in age, race, education, comorbidities, and the age at and cause of menopause. The SMD of the effect of HT on urine proteinuria/albuminuria in the randomized control trials (n = 3) was 0.02 (95% CI, -0.29 to 0.33) and -0.13 (95% CI, -0.31 to 0.05) in the observational studies (n = 9). There was significantly less albuminuria among HT users (SMD -0.15, 95% CI, -0.27 to -0.04) in the 9 studies that only reported albuminuria as an outcome and in the 10 studies with a comparator arm (SMD -0.15, 95% CI, -0.26 to -0.04). conclusions: HT is associated with decreased odds of albuminuria, but some of the observed benefits may be related to reported outcomes, the presence of a comparator arm, and the type of study design.

Original languageEnglish (US)
Pages (from-to)625-634
Number of pages10
JournalMenopause
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2018

Fingerprint

Albuminuria
Meta-Analysis
Cohort Studies
Urine
Hormones
Confidence Intervals
Proteins
Molecular Epidemiology
Therapeutics
Menopause
Proteinuria
Observational Studies
Comorbidity
Albumins
Creatinine
Estrogens
Theoretical Models
Odds Ratio
Outcome Assessment (Health Care)
Education

Keywords

  • Albuminuria
  • Estrogen
  • Hormone therapy
  • Proteinuria

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Hormone therapy and urine protein excretion : A multiracial cohort study, systematic review, and meta-analysis. / Kattah, Andrea G.; Suarez, Maria L.G.; Milic, Natasa; Kantarci, Kejal M; Zeydan, Burcu; Mosley, Thomas; Turner, Stephen T; Ware, Erin B.; Kardia, Sharon L.R.; Garovic, Vesna D.

In: Menopause, Vol. 25, No. 6, 01.06.2018, p. 625-634.

Research output: Contribution to journalReview article

Kattah, Andrea G. ; Suarez, Maria L.G. ; Milic, Natasa ; Kantarci, Kejal M ; Zeydan, Burcu ; Mosley, Thomas ; Turner, Stephen T ; Ware, Erin B. ; Kardia, Sharon L.R. ; Garovic, Vesna D. / Hormone therapy and urine protein excretion : A multiracial cohort study, systematic review, and meta-analysis. In: Menopause. 2018 ; Vol. 25, No. 6. pp. 625-634.
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abstract = "Objective: Experimental models suggest estrogen has a renoprotective effect, but human studies show variable results. Our objective was to study the association of hormone therapy (HT) and albuminuria in postmenopausal women and to synthesize the results with outcomes from prior studies. Methods: We analyzed data from postmenopausal women who participated in the second study visit (2000- 2004) of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. The exposure was self-reported HT use and the outcome was albuminuria (urine albumin-to-creatinine ratio >25 mg/g Cr). We also conducted a systematic review and meta-analysis on the association of HT and urine protein in postmenopausal women. Continuous and dichotomous measures of protein excretion were converted to a standardized mean difference (SMD) for each study. Results: In the GENOA cohort (n = 2,217), there were fewer women with albuminuria among HT users than nonusers (9{\%} vs 19{\%}, P < 0.001). HT use was associated with decreased odds of albuminuria (odds ratio 0.65, 95{\%} confidence interval (CI), 0.45-0.95), after adjusting for significant differences in age, race, education, comorbidities, and the age at and cause of menopause. The SMD of the effect of HT on urine proteinuria/albuminuria in the randomized control trials (n = 3) was 0.02 (95{\%} CI, -0.29 to 0.33) and -0.13 (95{\%} CI, -0.31 to 0.05) in the observational studies (n = 9). There was significantly less albuminuria among HT users (SMD -0.15, 95{\%} CI, -0.27 to -0.04) in the 9 studies that only reported albuminuria as an outcome and in the 10 studies with a comparator arm (SMD -0.15, 95{\%} CI, -0.26 to -0.04). conclusions: HT is associated with decreased odds of albuminuria, but some of the observed benefits may be related to reported outcomes, the presence of a comparator arm, and the type of study design.",
keywords = "Albuminuria, Estrogen, Hormone therapy, Proteinuria",
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T1 - Hormone therapy and urine protein excretion

T2 - A multiracial cohort study, systematic review, and meta-analysis

AU - Kattah, Andrea G.

AU - Suarez, Maria L.G.

AU - Milic, Natasa

AU - Kantarci, Kejal M

AU - Zeydan, Burcu

AU - Mosley, Thomas

AU - Turner, Stephen T

AU - Ware, Erin B.

AU - Kardia, Sharon L.R.

AU - Garovic, Vesna D

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Objective: Experimental models suggest estrogen has a renoprotective effect, but human studies show variable results. Our objective was to study the association of hormone therapy (HT) and albuminuria in postmenopausal women and to synthesize the results with outcomes from prior studies. Methods: We analyzed data from postmenopausal women who participated in the second study visit (2000- 2004) of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. The exposure was self-reported HT use and the outcome was albuminuria (urine albumin-to-creatinine ratio >25 mg/g Cr). We also conducted a systematic review and meta-analysis on the association of HT and urine protein in postmenopausal women. Continuous and dichotomous measures of protein excretion were converted to a standardized mean difference (SMD) for each study. Results: In the GENOA cohort (n = 2,217), there were fewer women with albuminuria among HT users than nonusers (9% vs 19%, P < 0.001). HT use was associated with decreased odds of albuminuria (odds ratio 0.65, 95% confidence interval (CI), 0.45-0.95), after adjusting for significant differences in age, race, education, comorbidities, and the age at and cause of menopause. The SMD of the effect of HT on urine proteinuria/albuminuria in the randomized control trials (n = 3) was 0.02 (95% CI, -0.29 to 0.33) and -0.13 (95% CI, -0.31 to 0.05) in the observational studies (n = 9). There was significantly less albuminuria among HT users (SMD -0.15, 95% CI, -0.27 to -0.04) in the 9 studies that only reported albuminuria as an outcome and in the 10 studies with a comparator arm (SMD -0.15, 95% CI, -0.26 to -0.04). conclusions: HT is associated with decreased odds of albuminuria, but some of the observed benefits may be related to reported outcomes, the presence of a comparator arm, and the type of study design.

AB - Objective: Experimental models suggest estrogen has a renoprotective effect, but human studies show variable results. Our objective was to study the association of hormone therapy (HT) and albuminuria in postmenopausal women and to synthesize the results with outcomes from prior studies. Methods: We analyzed data from postmenopausal women who participated in the second study visit (2000- 2004) of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. The exposure was self-reported HT use and the outcome was albuminuria (urine albumin-to-creatinine ratio >25 mg/g Cr). We also conducted a systematic review and meta-analysis on the association of HT and urine protein in postmenopausal women. Continuous and dichotomous measures of protein excretion were converted to a standardized mean difference (SMD) for each study. Results: In the GENOA cohort (n = 2,217), there were fewer women with albuminuria among HT users than nonusers (9% vs 19%, P < 0.001). HT use was associated with decreased odds of albuminuria (odds ratio 0.65, 95% confidence interval (CI), 0.45-0.95), after adjusting for significant differences in age, race, education, comorbidities, and the age at and cause of menopause. The SMD of the effect of HT on urine proteinuria/albuminuria in the randomized control trials (n = 3) was 0.02 (95% CI, -0.29 to 0.33) and -0.13 (95% CI, -0.31 to 0.05) in the observational studies (n = 9). There was significantly less albuminuria among HT users (SMD -0.15, 95% CI, -0.27 to -0.04) in the 9 studies that only reported albuminuria as an outcome and in the 10 studies with a comparator arm (SMD -0.15, 95% CI, -0.26 to -0.04). conclusions: HT is associated with decreased odds of albuminuria, but some of the observed benefits may be related to reported outcomes, the presence of a comparator arm, and the type of study design.

KW - Albuminuria

KW - Estrogen

KW - Hormone therapy

KW - Proteinuria

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DO - 10.1097/GME.0000000000001062

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