Abstract: FR-PO1138
Variation in the Sex Coefficient of GFR-Estimating Equations: A Systematic Review
Session Information
- CKD: Screening, Diagnosis, Serum and Urine Biomarkers, and Scoring Indices
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Ramesh, Sharanya, Tufts Medical Center, Boston, Massachusetts, United States
- Srivastava, Aman, Tufts University School of Medicine, Boston, Massachusetts, United States
- Adingwupu, Ogechi M., Tufts Medical Center, Boston, Massachusetts, United States
- Levey, Andrew S., Tufts Medical Center, Boston, Massachusetts, United States
- Inker, Lesley Ann, Tufts Medical Center, Boston, Massachusetts, United States
Background
Glomerular filtration rate (GFR) is estimated by serum concentrations of endogenous filtration markers, which are impacted by non-GFR determinants. Sex and other demographic variables are surrogates for the non-GFR determinants. Understanding the variation of the sex coefficient will provide information about the factors that impact sex dependent non-GFR determinants.
Methods
We conducted a systematic review to identify estimating equations that included sex as a variable to estimate GFR in MEDLINE, EMBASE, PubMed. Abstracts and full texts reviews were completed independently by two reviewers. Risk of bias was determined using the QUADAS-2 tool.
Results
117 studies of 207 equations were included in final analyses. The sex coefficient was evaluated in 54 equations (adults n=30, pediatrics n=8, both n=12, unknown n=4) using linear regression without use of splines, sex specific standardized filtration marker, exponents, or derivation using artificial neural network. In all equations that used serum creatinine(Scr) as the sole filtration marker or Scr without a surrogate for body composition, inclusion of a sex coefficient improved the accuracy of the estimating equation (figure 1) versus 56% of equations that used serum cystatin C as the sole filtration marker. In 23 equations using markers other than Scr alone (adults n=9), including a sex coefficient did not significantly improve the accuracy of the equations. The median (IQR) sex coefficients of the remaining 31 equations by filtration marker is presented in Fig 1.
Conclusion
These results highlight the variation in the sex coefficient based on filtration marker. Understanding the variation of the sex coefficient by these factors is the first step in understanding the drivers of sex-dependent non-GFR determinants of creatinine as the existence of multiple equations may lead to differences in the prevalence, risk, and treatment of CKD by sex.
Value of female sex coefficient[median (IQR)] by filtration marker
Funding
- Private Foundation Support