Ginsburg E, Price D, Chertow G, Walsh B, Lazarus JM,
Greenberg L, Owen WF
Estrogen replacement therapy for cardiovascular risk in
postmenopausal women with ESRD
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1447 1996
In healthy post-menopausal women, low dose estrogen has beneficial
effects on lipid abnormalities associated with cardiovascular risk.
Many women with ESRD are post-menopausal, and ESRD has its own
deleterious effects on lipid metabolism.
This randomized, placebo-controlled, crossover study was performed on
10 post-menopausal women with ESRD. Each treatment period was for two
months, with a 1 month washout period. Estrogen (2mg po) use resulted
in significant increases in HDL, HDL2, and Apo A-I, as well as
triglycerides. LDL, VLDL, and Lp(a) were not affected. The authors
conclude that the increase in HDL results in a significant reduction
in CV risk, and that low dose estrogen is safe and beneficial in this
population.
Comment: Improvement of biochemical parameters doesn't always
prove that the expected benefit will occur. Clearly, long term studies
of estrogen, as well as other anti-lipid agents, are needed in the
ESRD population. The long term safety and efficacy of estrogens is of
particular interest in ESRD due to their use in treatment of
gastrointestinal arteriovenous malformations. (James A. Sondheimer MD,
Wayne State
University, Detroit, MI)
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Am Soc Nephrol
CRF by organ system :
CRF in Women
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Cardiovascular/Hypertension