Kidney Week

Abstract: TH-PO746

Effect of Hormonal Contraception on Kidney Outcomes in Females: A Systematic Review and Meta-Analysis

Session Information

• Sex and Reproductive Factors in Kidney Health
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Chang, Danica H., University of Calgary, Calgary, Alberta, Canada

Danica H. Chang,

• Riehl-Tonn, Victoria J., University of Calgary, Calgary, Alberta, Canada

Victoria J. Riehl-Tonn,

• Ronksley, Paul E., University of Calgary, Calgary, Alberta, Canada

Paul E. Ronksley,

• Ahmed, Sofia B., University of Calgary, Calgary, Alberta, Canada

Sofia B. Ahmed,

• Ganshorn, Heather, University of Calgary, Calgary, Alberta, Canada

Heather Ganshorn,

• Brennand, Erin Alexandra, University of Calgary, Calgary, Alberta, Canada

Erin Alexandra Brennand,

• Dumanski, Sandi M., University of Calgary, Calgary, Alberta, Canada

Sandi M. Dumanski,

Background

Over 70% of reproductive-aged females in Canada use contraception. Previous literature demonstrates that hormonal contraception has important implications for cardiovascular health, but its effect on kidney health outcomes is poorly understood. Therefore, this systematic review and meta-analysis aimed to determine the effect of hormonal contraception on kidney outcomes in females.

Methods

A literature search of MEDLINE, Embase, and CENTRAL (from database inception-November 2021) was developed and reviewed by a health librarian, to identify original studies that reported kidney health outcomes (e.g., kidney function, proteinuria, progression or development of chronic kidney disease or kidney failure) in female hormonal contraception users. Two independent reviewers evaluated articles, extracted data, and assessed study quality in duplicate using the National Institutes of Health Study Quality Assessment Tools. Outcome measures were reported as weighted mean differences and meta-analyzed using a random effects model. Heterogeneity was assessed with the I² statistic. A stratified meta-analysis by type of hormonal contraception (oral vs other) was conducted for the outcome of change in serum creatinine.

Results

Of the 10,350 references identified within the search strategy, 18 observational studies were included, and 14 were eligible for meta-analysis. Most studies reported on oral contraceptives (N=14). Meta-analyses revealed no difference in mean serum creatinine [0.00 mg/dL (95% CI: -0.05, 0.05); I²=68.5%], creatinine clearance [10.01 mL/min (95% CI: -1.48, 21.50); I²=90.6%], and estimated glomerular filtration rate [0.37 mL/min/1.73m² (95% CI: -8.77, 9.51); I²=37.1%] between hormonal contraception users and non-users. When stratified by type of hormonal contraception, the overall pooled estimate also showed no difference in serum creatinine between groups. Overall study quality was fair.

Conclusion

This systematic review and meta-analysis found no association between hormonal contraception and various kidney outcomes. While the included studies had significant limitations and heterogeneity, this highlights the need for rigorous prospective studies examining the effect of hormonal contraception on kidney outcomes in females.

Funding

• Government Support – Non-U.S.