Chronic kidney disease in postmenopausal women

Abstract

Menopause is derived from the Greek words men (month) and pauses (cessation) and means permanent cessation of menstruation after the loss of ovarian activity. Chronic kidney disease (CKD) has recently been associated with cardiovascular events in several studies. CKD patients have a heavy burden of traditional cardiovascular risk factors in addition to a range of nontraditional risk factors such as inflammation and abnormal metabolism of calcium and phosphate. In this review, the association of CKD and cardiovascular disease (CVD), as well as of osteoporosis in postmenopausal women is discussed. CKD mineral and bone disorder, characterized by disturbances of calcium/phosphate/parathyroid hormone, bone abnormalities and vascular and soft tissue calcification, is highly prevalent in CKD and is a strong, independent predictor of bone fracture, CVD and death. Estrogen has been shown to: (a) decrease the expression of angiotensin type 1 receptors in vasculature and kidneys; (b) reduce the expression and activity of angiotensin-converting enzyme, and (c) cause the release of angiotensinogen substrate from the liver. However, the degree of activation or suppression of the renin-angiotensin-aldosterone system by estrogen has not been clearly established. Clinical data on the effects of estrogen therapy on bone mineral densities are extremely limited in the ESRD population. CVD is the most common cause of death in postmenopausal women with CKD and many contributing factors have been explored. INTRODUCTIONMenopause is derived from the Greek words men (month) and pauses (cessation) and means permanent cessation of menstruation after the loss of ovarian activity. Clinically, menopause is defined as the absence of menstruation for 12 months. 1 In clinical medicine, it is well known that menopause is associated with accelerated progression of vascular diseases and osteoporosis as a long-term health risk in women. Indeed, menopausal status increases the risk of cardiovascular disease (CVD) by more than three-fold in women with normal kidney function. 2 Several factors such as the prevalence of hypertension, 3 diabetes, 4 dyslipidemia 5 and so on are known contributors to CVD. In addition to these factors, several studies reveal that chronic kidney disease (CKD) is closely related with CVD events. 6-9 Moreover, Perticone et al. 10 have recently demonstrated that the reduction of estimated glomerular filtration rate (GFR) was associated with the increased risk of death and CVD events, independently of traditional CV risk factors, menopause duration and presence of metabolic syndrome.In addition to these risks in CVD, women lose an average of 25 percent of their bone mass from the time of menopause to age 60, due in large part to the loss of estrogen. Over time, this loss of bone mass can lead to osteoporosis and its related fractures are a serious problem affecting postmenopausal women. 11 Recently, two serious sequels of menopause have been closely associated with CKD. CKD is associated with accelerated progression of CVD, per...

Blood pressure and water regulation: understanding sex hormone effects within and between men and women

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Moderate‐to‐high normal levels of thyrotropin is a risk factor for urinary incontinence and an unsuitable quality of life in women over 65 years

“…Likewise, the percentage of women with diabetes was high, which could favour their appearance . Other factors like urinary retention and a high post‐void residual urine that have been also associated with urinary infections were not analyzed in the present study. However, they are common in older women …”

“…Post‐menopause is linked to an impaired function of the genitourinary tract. Thus, vulvovaginal atrophy, sexual dysfunctions, urine retention, urinary incontinence (UI), renal dysfunctions, and urinary infections are common among post‐menopausal women . Moreover, genitourinary dysfunctions worsen the quality of life of women …”

Non-alcoholic Fatty Liver Disease and Chronic Kidney Disease in Koreans Aged 50 Years or Older

“…The subjects 50 years and older were enrolled in our study because kidney diseases in older people, especially menopausal women, have generally been shown to be related with the sex hormones through the renin-angiotensin-aldosterone system 12). A total of 3,011 subjects received their routine health examination between May 2008 and April 2010 at Konkuk University medical center.…”