Chronic Kidney Disease More Common After Pre-menopausal Oophorectomy

The following is an excerpt from Journal Watch by the New England Journal of Medicine about a recent publication.

Women who have both ovaries removed before menopause may face increased risk for Chronic Kidney Disease (CKD), according to a study in the Clinical Journal of the American Society of Nephrology.

Nearly 1700 women in Minnesota who underwent bilateral Oophorectomy before menopause were matched to 1700 who did not have the procedure. During roughly 14 years’ follow-up, 211 women in the Oophorectomy group and 131 in the matched group developed CKD.

After adjustment for confounders, Oophorectomy was associated with a 42% increased risk for CKD. The risk was higher among women who had Oophorectomy before age 46 and those who didn’t receive estrogen therapy.

The researchers note that “animal models support the hypothesis that estrogen deprivation may have important direct harmful effects on kidney structure and function.” They add, “Women considering bilateral Oophorectomy for the prevention of ovarian cancer … need to be counseled regarding the potential risks of multi-morbidity, which may include the risk of CKD.”

This article highlights another reason why we avoid removing ovaries during a Hysterectomy in most patientseven for endometriosis. There’s an increased risk of poor functioning kidney.  This adds to the known effects of early menopause, shorter lifespan, greater risk for heart disease, osteoporosis, and cognitive impairment.  National recommendations are already to avoid removing the ovaries in patients under 65 at time of hysterectomy and this population based cohort study adds to our understanding of the effects on the kidneys.