# Menopauze verstoort lever-nier-metabool evenwicht; hormoontherapie niet bewezen voor MASLD- of CKD-preventie

*geplaatst 2026-08-29 · Nierziekte · Advances in therapy · doi 10.1007/s12325-026-03758-2 · https://hartvaat.nl/2026/08/22/menopauze-verstoort-lever-nier-metabool-evenwicht-hormoontherapie-niet-bewezen-v/*

Dit conceptuele overzicht beschrijft hoe de menopauze via veranderingen in vetverdeling, insulinegevoeligheid en ontsteking de lever-nier-metabool (LKM)-as verstoort, wat het risico op MASLD en chronische nierziekte (CKD) verhoogt. Hoewel menopauzale hormoontherapie (MHT) sommige metabole veranderingen kan milderen, is er momenteel geen bewijs dat MHT kan worden ingezet voor de preventie of behandeling van MASLD of CKD. Voor cardiologen, internisten en huisartsen betekent dit dat de focus bij peri- en postmenopauzale vrouwen moet blijven liggen op gevestigde risicomanagement en dat MHT uitsluitend op basis van de standaardindicaties moet worden voorgeschreven.

## English: Impact of Menopause and Menopausal Hormone Therapy on Liver-Kidney-Metabolic Health.

This narrative review outlines how menopause disrupts the liver-kidney-metabolic (LKM) axis through shifts in fat distribution, insulin sensitivity, and inflammation, thereby increasing the risk of MASLD and chronic kidney disease. While menopausal hormone therapy may partially mitigate some metabolic changes, current evidence does not support its use for preventing or treating MASLD or CKD. For clinicians, this reinforces that cardiovascular and renal risk management in peri- and postmenopausal women should remain guideline-driven, with hormone therapy reserved for established indications rather than metabolic protection.

## Abstract (original, from the publication)

Menopause is associated with unfavorable metabolic changes that may contribute to the development of metabolic dysfunction-associated steatotic liver disease (MASLD), chronic kidney disease (CKD), and increased cardiometabolic risk. Within the evolving cardiovascular-kidney-metabolic (CKM) framework, MASLD is increasingly recognized as a key driver rather than an outcome of metabolic dysfunction. The liver and kidneys closely interact to regulate metabolism, detoxification, ketogenesis, and endocrine signaling, which together influence whole-body metabolic homeostasis. Menopause and the menopausal transition may modify these interactions through alterations in body fat distribution, insulin sensitivity, inflammatory signaling, and hepatic and renal physiology, thereby contributing to disruption of the increasingly recognized liver-kidney-metabolic (LKM) axis. Advanced MASLD, owing to liver fibrosis, may further accelerate CKD through systemic insulin resistance, subclinical inflammation, gut dysbiosis, and accumulated nephrotoxic metabolites. Menopausal hormone therapy (MHT) may partially mitigate these alterations; however, its effects on the LKM axis are variable and context-dependent according to timing, formulation, route of administration, and baseline metabolic phenotype. Current evidence does not support the use of MHT for the prevention or treatment of MASLD or CKD, and treatment should be guided by established indications. Understanding menopause as a systems-level modifier of LKM health may therefore support more personalized preventive and therapeutic strategies targeting CKM health in peri- and postmenopausal women through a holistic and integrated approach.

Auteurs: Mohamad Jamalinia, Amedeo Lonardo, Ralf Weiskirchen

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Bron: Advances in therapy, https://doi.org/10.1007/s12325-026-03758-2. Bijgewerkt 2026-08-23T00:49:29Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.