Endometriosis Might Be Inversely Associated with Developing Chronic Kidney Disease: A Population-Based Cohort Study in Taiwan

Abstract

This study was conducted to determine the risk of chronic kidney disease (CKD) among women with endometriosis in Taiwan. We conducted a retrospective cohort study using the National Health Insurance Research Database of Taiwan. A total of 27,973 women with a diagnosis of endometriosis and 27,973 multivariable-matched controls (1:1) from 2000 to 2010 were selected. Cox regression and computed hazard ratios (HR) with 95% confidence intervals (95% CI) were used to determine the risk of CKD among women with endometriosis. The incidence rates (IR, per 10,000 person-years) of CKD among women with and without endometriosis were 4.64 and 7.01, respectively, with a significantly decreased risk of CKD (crude HR 0.65, 95% CI 0.53–0.81; adjusted HR 0.69, 95% CI 0.56–0.86) among women with endometriosis. The IR of CKD progressively increased with age, but the trend of lower CKD risk among women with endometriosis was consistent. However, the lower risk of CKD in women with endometriosis was no longer statistically significant after adjusting for menopausal status (adjusted HR 0.85, 95% CI 0.65–1.10). The results suggest that endometriosis is inversely associated with CKD, but this effect was mediated by menopause. The possible mechanism of this association is worthy of further evaluation.

Risks of female genital tract related cancers (gynecological cancers) or breast cancer in women with and without chronic kidney disease

“…The IRs of EOC/TC in the women with CKD aged <40, 40 to 49, 50 to 59, 60 to 69, and ≥70 years were 0, 0, 1.79, 0.72, and 1.7, respectively, and the mean of these IRs (0.84 per 10,000 persons) was consistent to age-standardized IR (SIR) of EOC in the general population in Taiwan. [ 58 ] In our previous nationwide population-based studies for the study of risk of EOC in the certain population, such as endometriosis or others, [ 13 , 59 – 61 ] IRs of EOC in the controls ranged from 0.77 to 0.89, which were very much similar to age-SIR in Taiwan and also consistent with the reports from the world. [ 53 – 57 ] By contrast, IRs of EOC in the non-CKD women were 2.30, 2.71, 3.61, 1.49, and 5.28 with a mean of at the age <40, 40 to 49, 50 to 59, 60 to 69, and ≥70 years, respectively (Supplement Table 2), which were significantly higher than the age-SIR of EOC/TC in the general population (0.7–0.9 per 10,000 person-years), contributing to the underestimated risk of EOC/TC in the women with CKD.…”

“…In order to match this, we found that our studied subjects for controls were stayed in the low SES, and these controls were significantly different from those in the other nationwide, population-based studies in Taiwan. [ 13 , 64 – 67 ]…”

<p>Risk factors for developing depression in women with cervical cancer: a nationwide population-based study in Taiwan</p>

“…In Taiwan, >96% of residents are covered by the National Health Insurance (NHI) program, and 93% of medical institutions are contracted to the administration of the NHI. Through the contracted institutes, the insurance beneficiaries may utilize health services 30. The NHI Research Database (NHIRD), regarded as a population-based source, can be employed to search for a patient’s date of diagnosis, medical treatments, chemotherapy, and radiotherapy.…”

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

“…If a three-fold increase in liver enzymes of patients was detected, paclitaxel (60 mg/m 2 ) was used. The cisplatin dose was decreased to half dosage if the estimated glomerular filtration rate (eGFR) was decreased to 45-60 ml/min, which was calculated using the Cockcroft-Gault formula [122][123][124].…”