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In a [i]post hoc[/i] analysis, an increased risk of nephrolithiasis (renal stones) has been reported amongst users of hormone replacement therapy (HRT) in the Women’s Health Initiative (WHI) randomized, controlled trial [1]. A total of 10,739 postmenopausal women were included in the estrogen-alone vs. placebo trial (average follow-up 7.1 years), whereas 16,608 women composed the estrogen + progestin vs. placebo trial (average follow-up 5.6 years). The overall relative risk was 1.21 (95% confidence interval 1.03–1.44) which, in absolute terms, amounted to five extra cases of renal stones per 10,000 women per year (39 cases in the active treatment arms vs. 34 cases in the placebo arms). The increased nephrolithiasis risk was independent of progestin co-administration.


  • Rodney J. Baber
    Associate Professor of Obstetrics and Gynaecology at The University of Sydney, Head, Menopause Unit, The Royal North Shore Hospital of Sydney, New South Wales, Australia


  1. Maalouf NM, Sato AH, Welch BJ, et al. Postmenopausal hormone use and the risk of nephrolithiasis. Arch Intern Med 2010;170:1678-85.
  2. Worcester EM, Coe FL. Calcium kidney stones. N Engl J Med 2010;363:954-63.
  3. Fan J, Chandhoke P, Grampsas S. Role of sex hormones in experimental calcium oxalate nephrolithiasis. J Sam Soc Nephrol 1999;10:S376-80.
  4. Heller HJ, Sakhaee K, Moe OW, Pak CY. Etiological role of estrogen status in renal stone formation. J Urol 2002;168:1923-7.
  5. Mattix Kramer HJ, Grodstein F, Stampfer MJ, Curhan GC. Menopause and post menopausal hormone use and risk of incident kidney stones. J Am Soc Nephrol 2003;14:1272-7.
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