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Review
. 2024 Feb 22;13(5):1257.
doi: 10.3390/jcm13051257.

Role of Female Sex Hormones in ADPKD Progression and a Personalized Approach to Contraception and Hormonal Therapy

Micaela Petrone  1 , Martina Catania  2   3 , Liliana Italia De Rosa  2   3 , Rebecca S Degliuomini  1   3 , Kristiana Kola  2   3 , Chiara Lupi  1   3 , Matteo Brambilla Pisoni  2 , Stefano Salvatore  1   3 , Massimo Candiani  1   3 , Giuseppe Vezzoli  2   3 , Maria Teresa Sciarrone Alibrandi  2
Affiliations
Review

Role of Female Sex Hormones in ADPKD Progression and a Personalized Approach to Contraception and Hormonal Therapy

Micaela Petrone et al. J Clin Med. .

Abstract

This review navigates the intricate relationship between gender, hormonal influences, and the progression of autosomal dominant polycystic kidney disease (ADPKD), highlighting the limited literature on this crucial topic. The study explores the impact of female sex hormones on liver and renal manifestations, uncovering gender-specific differences in disease progression. Actually, hormonal therapy in women with ADPKD remains a challenging issue and is a source of concern regarding its potential impact on disease outcomes, particularly at the hepatic level. Notably, women with ADPKD exhibit a slower renal disease progression compared to men, attributed to hormonal dynamics. This review sheds light on the role of estrogen in regulating pathways of the renin-angiotensin-aldosterone system, revealing its complex interplay and implications for cardiovascular and renal health. Therapeutic considerations for fertile women with ADPKD, including contraception options, are discussed, emphasizing the necessity for personalized approaches. In the postmenopausal phase, the review evaluates the role of hormonal replacement therapy, considering its potential benefits and risks in the context of ADPKD. The review concludes by underscoring the imperative need for tailored treatment approaches for ADPKD patients, considering individual risks and benefits. The scarcity of literature underlines the call for further research to enhance our understanding of optimal hormonal therapies in the context of ADPKD, ultimately paving the way for innovative and personalized therapeutic interventions.

Keywords: ADPKD; childbearing age; contraception; female sexual hormones; hormonal therapy; menopausal transition; polycystic kidney.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
41 years old ADPKD women with nephromegaly and hepatomegaly. Two previous pregnancies and 5 years of estroprogestinic pill. Mayo Class 1 E. Orange arrow: lower margin of the right hepatic lobe; blue arrow: right kidney; green arrow: left kidney.
Figure 2
Figure 2
RAAS activity according to female hormonal changes.
Figure 3
Figure 3
Possible therapeutic algorithm.
See this image and copyright information in PMC

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