Kidney Week

Abstract: FR-PO0982

Premenopausal Endogenous Estrogen Exposure and Postmenopausal Kidney Function: Data from the Women's Health Initiative

Session Information

• Women's Health and Kidney Diseases
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Ostrow, Anna, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Anna Ostrow, MPH

• Lapierre-Nguyen, Stephanie, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Stephanie Lapierre-Nguyen, PhD

• Oh, Ester, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Ester Oh, PhD

• Franceschini, Nora, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Nora Franceschini, MD, MPH

• Nowak, Kristen L., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Kristen L. Nowak, PhD, MPH

Background

Female-specific reproductive health risk factors, such as premature menopause, infertility, and adverse pregnancy outcomes have been associated with an increased risk of cardiovascular disease and type 2 diabetes. However, the association between these risk factors and renal impairment has not been well explored. Recent evidence suggests an association between several women’s reproductive factors (e.g., menopause before age 45, age at menarche, number of miscarriages) and a higher risk of chronic kidney disease (CKD). The current study quantifies total premenopausal estrogen exposure to examine associations with kidney function later in life.

Methods

We analyzed baseline data from the Women’s Health Initiative (WHI) observational study, which included post-menopausal women ages 50-79 who completed questionnaires at study enrollment regarding their reproductive history. Total endogenous estrogen exposure was calculated as the sum of total reproductive years, lifetime live births, stillbirths, and miscarriages minus lifetime lactation duration. Estimated glomerular filtration rate (eGFR) was calculated using the 2021 CKD-EPI equation. Linear regression examined associations between total endogenous estrogen exposure as a primary predictor and eGFR and adjusted for covariates including reproductive health history and cardiovascular risk factors.

Results

A total of 10,613 women were initially eligible for analysis based on availability of creatinine measurements. The average age was 63 years (SD 7) and the average eGFR was 87 mL/min/1.73m² (SD 16). In fully adjusted models, there was no significant association between total endogenous estrogen exposure and post-menopausal eGFR (β = 0.010; 95% CI -0.030, 0.050).

Conclusion

This is the first study to examine whether total endogenous estrogen exposure is associated with later in life kidney function in a cohort of postmenopausal women. The lack of association may indicate the need to calculate a more precise predictor of estrogen exposure (e.g., exogenous estrogen sources) to provide better prediction of kidney function.

Funding

• Other NIH Support