Postmenopausal estrogen therapy selectively stimulates hepatic enlargement in women with autosomal dominant polycystic kidney disease

• Published in: Hepatology (Baltimore, Md.) Vol. 26; no. 5; pp. 1282 - 1286
• Main Authors: Sherstha, R, McKinley, C, Russ, P, Scherzinger, A, Bronner, T, Showalter, R, Everson, G T
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-11-1997; Wiley
• Subjects: Antipyrine - pharmacokinetics; Biological and medical sciences; Caffeine - pharmacokinetics; Cysts - diagnostic imaging; Drug toxicity and drugs side effects treatment; Estrogen Replacement Therapy - adverse effects; Female; Hormones - blood; Humans; Kidney - diagnostic imaging; Liver - diagnostic imaging; Liver Diseases - diagnostic imaging; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Polycystic Kidney, Autosomal Dominant - diagnostic imaging; Polycystic Kidney, Autosomal Dominant - metabolism; Tomography, X-Ray Computed; Toxicity: digestive system; Liver; Menopause; Estrogen; Radiologic investigation; Variations; Hepatic disease; Kidney; Result; Mass volume; Female genital system; Cyst; Opotherapy; Female; Benign neoplasm; Biological effect; Kidney disease; Human; Urinary system disease; Radiodiagnosis; Polycystic kidney; Pharmacovigilance; Genetic disease; Symptomatology; Digestive diseases; Medical imagery; Computerized axial tomography
• ISSN: 0270-9139; 1527-3350
• DOI: 10.1002/hep.510260528

The goal of this study was to determine whether use of postmenopausal estrogen (Premarin®, Wyeth‐Ayerst, Philadelphia, PA) in women with autosomal dominant polycystic kidney disease (ADPKD) increases liver, hepatic cyst, or kidney volume. We also determined whether clinical symptoms correlated with the volume of either the liver or kidneys. Eight women off estrogen (control, C) and 11 others on estrogen (Premarin®, E) were studied basally and after 1 year. The two groups were similar in age, weight, age at menarche, and gravida. Volumes of total liver, hepatic cysts, hepatic parenchyma, and total kidney were measured by a validated computed tomography (CT) technique. Estrogen treatment was associated with a selective increase in total liver volume (E vs. C: Δ = 7% ± 12% vs. ‐2% ± 8%, P < .03) and no change in kidney volume (E vs. C: Δ = 0% ± 6% vs. ‐2% ± 6%, P = NS). Symptoms were common, regardless of estrogen treatment (abdominal pain 60%, shortness of breath 40%, or both 35%). Patients with symptoms of abdominal pain and shortness of breath had significantly increased hepatic volumes (P < .03) but similar kidney volume compared with patients without symptoms. We conclude that estrogen treatment of postmenopausal ADPKD women is associated with selective liver enlargement and that abdominal symptoms in ADPKD patients may be because of extensive hepatic cystic disease.