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Kidney

eGFR in women: normal values and pregnancy

The eGFR equations are not validated in pregnancy, yet kidney filtration rises 40 to 50 percent then. This page explains what your eGFR means across life stages. It also covers why protein in the urine sometimes says more.

Doctor's Assessment Included

When is this value abnormal?

Decision limits per result, in ml/min/1,73m²
Result Value (ml/min/1,73m²)
G5 – kidney failure < 15
G4 – severely decreased 15–30
G3b – moderately to severely decreased 30–45
G3a – mildly to moderately decreased 45–60
G2 – mildly decreased 60–90
G1 – normal or high ≥ 90

De eGFR wordt niet beoordeeld met één normaalwaarde, maar met de stadia G1 tot en met G5 uit de richtlijn Chronische nierschade (NHG/NIV, naar KDIGO). De waarde is een schatting: hij wordt met de CKD-EPI-formule berekend uit het kreatinine in uw bloed, uw leeftijd en uw geslacht. Het stadium alleen zegt nog niet of er nierschade is: daarvoor kijkt de arts ook naar de albumine-creatinineratio (ACR) in de urine, en of een afwijking ten minste 3 maanden aanhoudt. Ook bij stadium G1-G2 kan er nierschade zijn als de albuminurie verhoogd is; met een normale albuminurie geldt G1-G2 als geen chronische nierschade (samen circa 88% van de bevolking). Bij een eGFR onder de 60 die langer dan 3 maanden bestaat, spreekt men van chronische nierschade en past de huisarts zo nodig medicatiedoseringen aan. Bespreek uw uitslag met uw huisarts.

Source: NHG Reference population: Alle volwassenen (KDIGO/NHG-stadiëring, leeftijdsonafhankelijk)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

eGFR (Estimated Glomerular Filtration Rate): what this test measures

The equation behind your eGFR includes your sex as a variable. That is not an assumption about women's kidneys. It corrects for muscle mass, because creatinine comes from muscle tissue. Women on average carry less muscle than men. Without that correction results would sit structurally skewed.

There is a flip side. In a slight woman with little muscle the value can read too favourably. The kidney then filters less than the number suggests. CKD-EPI 2021 and the newer EKFC equation share that limitation.

The underlying creatinine shows where the number comes from. Cystatin C bypasses muscle mass entirely.

eGFR (Estimated Glomerular Filtration Rate): why this value matters

During pregnancy kidney filtration rises physiologically by 40 to 50 percent. The equations were never validated for that situation. An eGFR from a pregnancy check is therefore hard to read. Creatinine actually falls in that period. A value that looks normal for a non-pregnant woman may be on the high side in pregnancy.

After a pregnancy with pre-eclampsia the kidney deserves lasting attention. The risk of later kidney and cardiovascular disease is higher. In that follow-up the amount of protein in the urine weighs heavily. Damage can show there while eGFR is still normal.

Around menopause nothing specific changes in kidney function. The gradual age-related decline simply continues.

eGFR (Estimated Glomerular Filtration Rate): when is testing worthwhile?

Outside pregnancy eGFR is usually calculated alongside routine blood work. With diabetes, high blood pressure or kidney disease in the family that is especially useful. After pre-eclampsia kidney function belongs in long-term follow-up.

Never read a one-off low value as a diagnosis. Three months of the same result is what counts. Ask whether protein in the urine was measured too.

If your doctor doubts the number fits your build, cystatin C offers a way out. Always discuss an abnormal result with your doctor in person.

eGFR (Estimated Glomerular Filtration Rate): symptoms of a high or low value

Low Levels

Persistent fatigue and low energy
Fluid retention in the legs, ankles or around the eyes
High blood pressure, including after a pregnancy
Nausea or reduced appetite
Difficulty concentrating
Persistent foam on the urine

High Levels

A high value is usually not a cause for concern
During pregnancy filtration rises physiologically
That rise amounts to 40 to 50 percent
The equations are not validated for that situation
Outside pregnancy hyperfiltration can signal risk

eGFR (Estimated Glomerular Filtration Rate): what to do about an abnormal value

Female

If Low

Low eGFR indicates reduced kidney function. Consult a nephrologist for evaluation and management.

If High

Normal to high eGFR indicates healthy kidney function. Maintain kidney-healthy habits.

eGFR (Estimated Glomerular Filtration Rate): lifestyle and this value

Keep an eye on blood pressure and blood sugar, especially after a pregnancy with pre-eclampsia. Ask about protein in the urine at that follow-up. Damage often shows there before it shows in the eGFR.

Drink enough and eat varied meals without excess salt. Be careful with prolonged NSAID use. Discuss any medication with your doctor or midwife when trying to conceive or during pregnancy.

eGFR (Estimated Glomerular Filtration Rate): frequently asked questions

What is a normal GFR for age?

Above 90 is normal in young adults. After roughly age forty the value falls by about 1 ml/min per year. Around age 70 a value between 70 and 80 is very common. In people in their eighties 60 to 70 often still fits the age. A lower value is therefore not automatically disease.

Is eGFR accurate during pregnancy?

The equations were never validated for pregnancy. Kidney filtration rises physiologically by 40 to 50 percent in that period. Creatinine therefore falls. A value that looks normal for a non-pregnant woman may be on the high side in pregnancy. Have the result interpreted by your midwife or doctor.

Why does sex appear in the eGFR equation?

Not because women's kidneys work differently. Creatinine comes from muscle tissue and women on average carry less muscle. Without that correction results would sit structurally skewed. The flip side is that with little muscle the value can read too favourably.

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HbA1c (Glycated Hemoglobin) ALT (Alanine Aminotransferase) Calcium ALP (Alkaline Phosphatase) AST (Aspartate Aminotransferase) Bilirubin (Total) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Glucose (Fasting) Bicarbonate Chloride Sodium Potassium Albumin Total Protein Bilirubin (Direct) Bilirubin (Indirect)
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