J S Park1, H H Jung, W S Yang, S B Kim, W K Min, H S Chi. 1. Departments of Internal Medicine and Clinical Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Abstract
BACKGROUND:Hormone replacement therapy (HRT) has been known to have beneficial effects on various atherosclerotic parameters in the general population of post-menopausal women. To evaluate the effects of HRT on those factors in end-stage renal disease (ESRD) patients, we evaluated the changes of lipid profile, coagulation and fibrinolysis markers, and plasma homocysteine levels after treatment. METHODS:Sixty-five post-menopausal women on maintenance haemodialysis were randomly assigned to either an HRT group (n=33) or a control group (n=32). Median age (range) and duration of haemodialysis (range) were 57 years (40-73) and 42 months (6-150) in the HRT group and 61 years (44-78) and 54 months (8-174) in the control group respectively. Oral conjugatedoestrogen (0.625 mg) combined with medroxyprogesterone acetate (2.5 mg) was given daily for 12 weeks to the HRT group. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), fibrinogen, plasminogen activator type 1 antigen (PAI-1), tissue plasminogen antigen (t-PA), von Willebrand factor (vWF), and plasma total homocysteine (tHcy) were measured before and 12 weeks after the start of the study in both groups. RESULTS: There was no difference in baseline values between the control and HRT groups. At 12 weeks, HRT increased HDL-C by 12% (P:<0.01) and TG by 20% (P:<0. 01). HRT decreased LDL-C by 9% (P:<0.01), and Lp(a) by 36% (P:<0.01). PAI-1 and t-PA concentrations were also reduced by 21% (P:<0.01) and 9% (P:<0.05) respectively. The mean values of TC, fibrinogen, vWF, and tHcy levels did not change significantly after HRT. CONCLUSIONS: The above results suggest that HRT has favourable effects on atherosclerosis risk parameters in post-menopausal women with ESRD as in the general population of post-menopausal women.
RCT Entities:
BACKGROUND: Hormone replacement therapy (HRT) has been known to have beneficial effects on various atherosclerotic parameters in the general population of post-menopausal women. To evaluate the effects of HRT on those factors in end-stage renal disease (ESRD) patients, we evaluated the changes of lipid profile, coagulation and fibrinolysis markers, and plasma homocysteine levels after treatment. METHODS: Sixty-five post-menopausal women on maintenance haemodialysis were randomly assigned to either an HRT group (n=33) or a control group (n=32). Median age (range) and duration of haemodialysis (range) were 57 years (40-73) and 42 months (6-150) in the HRT group and 61 years (44-78) and 54 months (8-174) in the control group respectively. Oral conjugated oestrogen (0.625 mg) combined with medroxyprogesterone acetate (2.5 mg) was given daily for 12 weeks to the HRT group. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), fibrinogen, plasminogen activator type 1 antigen (PAI-1), tissue plasminogen antigen (t-PA), von Willebrand factor (vWF), and plasma total homocysteine (tHcy) were measured before and 12 weeks after the start of the study in both groups. RESULTS: There was no difference in baseline values between the control and HRT groups. At 12 weeks, HRT increased HDL-C by 12% (P:<0.01) and TG by 20% (P:<0. 01). HRT decreased LDL-C by 9% (P:<0.01), and Lp(a) by 36% (P:<0.01). PAI-1 and t-PA concentrations were also reduced by 21% (P:<0.01) and 9% (P:<0.05) respectively. The mean values of TC, fibrinogen, vWF, and tHcy levels did not change significantly after HRT. CONCLUSIONS: The above results suggest that HRT has favourable effects on atherosclerosis risk parameters in post-menopausal women with ESRD as in the general population of post-menopausal women.
Authors: Sharanya Ramesh; Michelle C Mann; Jayna M Holroyd-Leduc; Stephen B Wilton; Matthew T James; Ellen W Seely; Sofia B Ahmed Journal: Syst Rev Date: 2015-04-08