Informing patients of the risks and benefits of hormone replacement therapy: Nephrologists’ ethical obligation

As consultants, nephrologists are often in a position to observe and diagnose nonrenal illnesses as well as identify potential complications of previously prescribed therapies. The decision to discuss these types of issues with patients can be complicated by the fear of offending the patient’s primary care physician. When such situations pose potential harm to patients, they become ethical issues and the nephrologist’s responsibility to inform patients of potentially harmful exposure is clear. Given recent research findings, the use of hormone replacement therapy by many of the patients referred to nephrologists should be reviewed and discussed with the patient and the referring physician. All potential benefits and harms should be clearly stated.