Abstract: FR-PO394
Bilateral Oophorectomy and the Risk of CKD
Session Information
- CKD: Risk Factors for Incidence and Progression - I
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Chronic Kidney Disease (Non-Dialysis)
- 301 CKD: Risk Factors for Incidence and Progression
Authors
- Kattah, Andrea G., Mayo Clinic, Rochester, Minnesota, United States
- Smith, Carin Y, Mayo Clinic, Rochester, Minnesota, United States
- Garovic, Vesna D., Mayo Clinic, Rochester, Minnesota, United States
- Rocca, Walter A, Mayo Clinic, Rochester, Minnesota, United States
Background
Premenopausal women who undergo bilateral oophorectomy are at an increased risk for morbidity and mortality. Given the potential benefits of estrogen on renal structure and function, we hypothesized that women who undergo bilateral oophorectomy are at an increased risk of chronic kidney disease (CKD).
Methods
All premenopausal women who underwent bilateral oophorectomy for a noncancerous condition before age 50 years from 1/1/1988 to 12/31/2007 in Olmsted County, MN were identified and age-matched (± 1 year) to referent women who did not undergo oophorectomy. CKD was defined in 2 ways: (1) serum creatinine-based definition (Cr > 1.1 mg/dl on two occasions, greater than 90 days apart) and (2) medical record diagnosis of CKD (screening for diagnosis codes and confirmation by medical record review). The hazard ratio (HR) for CKD was estimated with Cox proportional hazards models using age as the time scale. Women with CKD before index were excluded from the analyses. Inverse probability weighting was used to balance the two cohorts with respect to 17 chronic diseases at the time of oophorectomy (or index date), age, education, race, BMI, smoking, and calendar year.
Results
There were 1,653 women with bilateral oophorectomy and 1,653 referent women, and the median length of follow-up was 14 years in both cohorts. Using the serum Cr-based definition, 69 referent women and 120 women with bilateral oophorectomy developed CKD, with an adjusted HR of 1.48 (95% CI 1.10-1.99). The adjusted HR was higher in women who underwent oophorectomy at age ≤ 45 years (HR 1.74 (95% CI 1.15-2.63). In a subgroup analysis of women without any chronic diseases at the index date, the risk of CKD remained significant (HR 1.85, 95% CI 1.12-3.05). Using the diagnosis of CKD confirmed at medical record review, 43 referent women and 61 women with bilateral oophorectomy developed CKD, with an adjusted HR of 1.17 (95% CI 0.79-1.74).
Conclusion
Premenopausal women who undergo bilateral oophorectomy are at an increased risk of developing CKD, even after adjusting for multiple chronic conditions. This risk may be due to the abrupt drop in systemic estrogen levels after surgery. Further research into the mechanism of renal injury and the correct dosage of hormone replacement after oophorectomy is needed.
Funding
- Other NIH Support