Menopause is associated with a reduction in glomerular filtration rate, independent of body composition and metabolic syndrome

Objectives: This study examines the relationship between menopause and glomerular filtration rate (GFR), independent of body composition and metabolic profile, both known risk factors for GFR decline. Study design: Cross-sectional study involving 3918 women aged 40–55 years. Main outcome measures: Participants provided information about medical history, menopausal status, and current medication use. Participants underwent nutritional and anthropometric assessments. Blood samples were collected to measure biochemical parameters. Menopause was defined as no menstrual cycle for 12 months or more. GFR was estimated using the EPI-CKD formula, and metabolic syndrome was identified using harmonized criteria. Premenopausal and postmenopausal women were matched by age, body composition, and metabolic syndrome factors to assess the menopause–GFR association. Results: Postmenopausal women exhibited higher fat mass, lower fat-free mass, and reduced GFR compared with premenopausal women. They also had higher rates of hypertension, impaired fasting glucose, and metabolic syndrome. After matching for age, fat mass index, fat-free mass index, and components of the metabolic syndrome, menopause was independently associated with a GFR reduction of 2.32 ml/min/1.73m2 (95 % CI: 3.81, 0.83). Additionally, menopause was linked to a 51 % higher risk of GFR <90 ml/min/1.73m2 (OR =1.51; 95 % CI 1.12, 2.02). Conclusions: Menopause represents an independent risk factor for GFR decline, beyond the effects related to body composition and metabolic risk factors.