Biomarkers · Renal & Purine

Estimated Glomerular Filtration Rate (eGFR)

Higher values go with lower risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 24% lower risk of death. We found the same pattern in NHANES

eGFR and risk of death

NHANES, our fit with 95% CIPublished curve

Published curve higher than the NHANES fitNHANES fit higher

Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.

Risk of death per SD (NHANES)0.76×95% CI 0.74–0.79 · 43,817 adults, 5,903 deaths

Published risk of death1.57×eGFR 45 vs 95 mL/min/1.73 m2 (reference) (95% CI 1.39–1.78) · CKD-PC meta-analysis of 14 general population cohorts with ACR (n=105,872)

Value of the measurement+0.024gain in concordance within age bands; rank 14 of 56 · all tests

eGFR by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table

Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (mL/min/1.73m2), from the survey named in the row. Not a reference range or a target.
Sex	Age	5th	25th	Median	75th	95th	n	Cycle / source
All	20-39	83.2	101	115	122	129	1,431	NHANES 2017-2018
All	40-59	67.0	85.7	98.9	107	115	1,548	NHANES 2017-2018
All	60+	44.9	64.9	78.8	92.3	101	1,890	NHANES 2017-2018
All	all	57.9	82.3	97.7	111	126	4,869	NHANES 2017-2018
Men	20-39	80.3	98.2	113	121	128	684	NHANES 2017-2018
Men	40-59	66.9	83.4	95.8	106	113	723	NHANES 2017-2018
Men	60+	48.0	67.3	81.4	92.9	101	958	NHANES 2017-2018
Men	all	59.7	82.6	96.4	111	124	2,365	NHANES 2017-2018
Women	20-39	85.6	103	116	124	130	747	NHANES 2017-2018
Women	40-59	67.3	87.7	101	108	115	825	NHANES 2017-2018
Women	60+	43.6	63.5	76.8	91.7	100	932	NHANES 2017-2018
Women	all	56.5	82.2	98.9	112	127	2,504	NHANES 2017-2018

What studies found when this marker was changed

They describe what happened in those study groups, not a recommendation. See all catalogued interventions.

Measured changes in eGFR, study by study

4 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Intervention	Reported effect	Evidence	Source
clinical	Intensive blood pressure normalization (<130/80 mmHg)	Reduced kidney failure composite (creatinine doubling/50% GFR decline/ESKD) in CKD: HR 0.82 (95% CI 0.68-0.98); ESKD HR 0.79	meta-analysis	Lv J, et al. Effects of intensive blood pressure lowering on the progression of…
pharmacologic	SGLT2 inhibitor (empagliflozin 10 mg daily) in chronic kidney disease	Halved chronic eGFR slope from -2.75 to -1.37 mL/min/1.73m2 per year (relative difference 50%, 95% CI 42-58) after an acute 2.12 mL/min/1.73m2 dip	RCT	EMPA-KIDNEY Collaborative Group. Effects of empagliflozin on progression of…
pharmacologic	Non-steroidal mineralocorticoid receptor antagonists (Finerenone)	Reduced kidney failure, sustained >=40% eGFR decline or renal death vs placebo (17.8% vs 21.1%; HR 0.82, 95% CI 0.73 to 0.93)	RCT	Bakris GL, et al. N Engl J Med. 2020;383:2219-2229.
pharmacologic	SGLT2 inhibitor empagliflozin	Slowed the chronic annual rate of eGFR decline by 64% vs placebo	meta-analysis	Herrington WG, et al. Effects of empagliflozin on conventional and exploratory…
pharmacologic	Subcutaneous semaglutide 1.0 mg once weekly in adults with type 2 diabetes and CKD (eGFR 25-75 with albuminuria)	Mean annual eGFR slope less steep by 1.16 mL/min/1.73m2 per year with semaglutide vs placebo (P<0.001)	RCT	Perkovic V, Tuttle KR, Rossing P, et al. Effects of Semaglutide on Chronic…
pharmacologic	Finerenone 10 or 20 mg daily on top of RAS inhibition in adults without diabetes who have CKD with albuminuria	Annual eGFR change -3.3 vs -4.0 mL/min/1.73m2 per year with placebo (difference 0.7, 95% CI 0.3-1.1)	RCT	Heerspink HJL, Neuen BL, Agarwal R, et al. Finerenone in Persons with Chronic…

Things that worsen it

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Condition or exposure	Reported effect	Evidence	Source
clinical	Type 2 diabetes with albuminuria (diabetic kidney disease)	eGFR declined -2.6 vs -1.5 mL/min/1.73 m2 per year in albuminuric vs normoalbuminuric type 2 diabetes over 5 years	cohort	Zhou L, et al. Baseline Urine Albumin-to-Creatinine Ratio is Associated With…
pharmacologic	Heavy radiocontrast exposure (primary coronary angioplasty)	Serum creatinine rose 25 percent or more after primary angioplasty in 33 percent of placebo patients (acute GFR loss)	RCT	Marenzi G, et al. N-acetylcysteine and contrast-induced nephropathy in primary…
pharmacologic	Finerenone 10 or 20 mg daily added to ACE inhibitor/ARB in adults with type 1 diabetes and albuminuric CKD	eGFR changed -5.6 vs -2.7 mL/min/1.73m2 with placebo at 6 months (difference -2.9, 95% CI -5.1 to -0.7); values approached baseline on washout	RCT	Heerspink HJL, Birkenfeld AL, Cherney DZI, et al. Finerenone in Type 1 Diabetes…

Sources

Risk curve: Matsushita K 2010 (PMID 20483451): all-cause HR 1.57 (1.39-1.78) eGFR 45 vs 95 mL/min/1.73 m2 (reference). Scaled to US values (NHANES).
Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375(9731):2073-81.
NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.

Map Estimated Glomerular Filtration Rate (eGFR) against another biomarker · Featured: Kidney function × blood pressure.

Map eGFR against another marker