Kidney Week

Abstract: FR-PO0269

Sex Hormone Levels and eGFR Assessed by Creatinine and Cystatin C in the Framingham Cohort Study

Session Information

• CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Ramesh, Sharanya, Tufts Medical Center, Boston, Massachusetts, United States

Sharanya Ramesh, MD, PhD

• Fino, Nora F., University of Utah Health, Salt Lake City, Utah, United States

Nora F. Fino, MS, PhD

• Adingwupu, Ogechi M., Tufts Medical Center, Boston, Massachusetts, United States

Ogechi M. Adingwupu, MD, MPH

• Levey, Andrew S., Tufts Medical Center, Boston, Massachusetts, United States

Andrew S. Levey, MD

• Inker, Lesley, Tufts Medical Center, Boston, Massachusetts, United States

Lesley Inker, MD, MS, FASN

Background

Glomerular filtration rate is estimated(eGFR) from the serum creatinine and cystatin C. Sex hormones may affect filtration markers by affecting GFR or non-GFR determinants. We aimed to investigate the associations between sex hormone levels and creatinine and cystatin C.

Methods

We analyzed cross-sectional data from the Framingham Heart Study Offspring cohort. Exposures were serum estradiol and testosterone; outcomes were eGFR creatinine(eGFRcr) and eGFR cystatin C(eGFRcys). Sex-stratified log-log linear regression models were fit as unadjusted, age/BMI/menopause-adjusted, and fully adjusted stepwise models. To assess effect modification, hormone-by-menopausal status interactions were tested in females(F) and hormone-by-age (median-dichotomized) interactions in males(M).

Results

3069 participants were included in the final analysis (M=1419, F=1650, mean age: M=61±9, F=61±9 years, mean eGFRcr: M=88±15, F=87±16 ml/min/1.73m² eGFRcys: M=82±19, F=81±18 ml/min/1.73m²). Men had a significantly higher testosterone, BMI, waist circumference and protein intake compared to women. Figure 1 shows associations between sex hormones and eGFR. In unadjusted models, higher testosterone associated positively with eGFRcr and eGFRcys in males but negatively with eGFRcys in females; higher estradiol associated positively with eGFRcr and eGFRcys in females but negatively with eGFRcys in males. After adjustment, testosterone was negatively associated with eGFRcr in males and estradiol with eGFRcys in females. No effect modification was observed by menopause or age.

Conclusion

Without measured GFR, we cannot distinguish the effects of GFR from non-GFR factors in these associations. The sex-specific associations between testosterone, estradiol, and filtration markers, particularly the differences between unadjusted and adjusted models, suggest they are associated with non-GFR determinants of both creatinine and cystatin C and warrant further investigation, especially regarding hormone metabolites that may illuminate mechanistic pathways linking sex hormones to GFR estimation.

Funding

• NIDDK Support – Chinook Therapeutics, Otsuka America Pharmaceutical, Alexion Pharmaceuticals, Novartis Pharmaceuticals Corporation