Influence of oral contraceptive agents on kidney function and protein metabolism

Abstract

The present study was an investigation of the effect of oral contraceptives on kidney function as well as a brief examination of protein metabolism, since glomerular filtration rate depends to a large extent on daily protein intake. 28 healthy women not taking contraceptives and 46 healthy women (aged 20-28 y) on one of three different types of oral contraceptive (combination preparations) were investigated [Minulet/Femovan, Marvelon, Diane]. In all groups on oral contraceptives the endogenous creatinine clearance was significantly increased. The potassium excretion rate was significantly elevated in the groups taking Marvelon and Diane, and the sodium excretion rate was significantly increased in those on Minulet/Femovan and Diane. In all groups on contraceptives the albumin excretion rate was numerically but not significantly elevated. No significant differences were found in the daily oral protein intake or the nitrogen excretion rate on comparing the groups taking contraceptives with the control group. However, the ratio nitrogen excretion rate/daily protein intake was significantly increased in those on Minulet/Femovan and Diane. The study has shown that besides their various effects on renal tubular function, oral contraceptives are able to increase the glomerular filtration rate, and certain types have a protein catabolic effect.

Oral Contraceptive Pill Alters Acute Dietary Protein‐Induced Thermogenesis in Young Women

“…The combined oral contraceptive pill has previously been associated with an increased gut transit time , decreased absorption of a variety of vitamins and minerals , and decreased serum albumin levels . It has been found, as well, to increase both endogenous creatinine clearance and the nitrogen excretion rate/daily protein intake ratio and to inhibit myofibrillar protein synthesis .…”

Female sex hormones, salt, and blood pressure regulation

“…19 The administration of OC has also been found to increase creatinine clearance in young women studied while receiving a free sodium intake. 57 Kang et al reported significant increases in systolic BP, renal vascular resistance, and filtration fraction in OC users compared with nonusers and showed that these differences were at least partially abolished by angiotensin II blockade. 58 Based on their data, the authors have suggested that despite humoral evidence of renin angiotensin system activation by OC, the tissue response may actually be down-regulated, perhaps at a receptor level.…”

“…There are few data on the renal hemodynamic effects of OC. 19,[55][56][57] An early study by Hollenberg et al has shown that OC in healthy young women reduces the effective renal plasma flow, an effect that appears to be due to an activation of the renin-angiotensin system by OC. 19 The administration of OC has also been found to increase creatinine clearance in young women studied while receiving a free sodium intake.…”

Diabetic kidney disease: impact of puberty

“…The RAS is activated by oral contraceptives, probably via an estrogen response element present in the promoter region of angiotensinogen (74). Oral contraceptives may also increase creatinine clearance (14). Men have higher plasma renin activity than agematched women (72), as well as higher blood pressures (121,161).…”