The effects of hormone replacement therapy on renal function

This Practice Point commentary discusses a study by Ahmed et al. that evaluated the effects of hormone replacement therapy (conjugated estrogen alone, progestin alone or a combination of progestin and conjugated estrogen) on renal function in elderly community-dwelling postmenopausal women. The authors found that oral estrogen therapy in this population was associated with accelerated decline in kidney function over a 2-year period. In addition, the cumulative amount of estrogen intake was dose-dependently associated with the rate of renal functional decline. This commentary highlights the human and experimental evidence suggesting that endogenous and exogenous estrogen affect renal function, and discusses the possible beneficial or detrimental effects of hormone supplementation on kidney function.