All pregnant women with preeclampsia are at increased risk of developing end-stage renal disease (ESRD), new study findings confirm.
Among 1,366,441 healthy pregnant women in Sweden during 1982 to 2012, 4.9% had preeclampsia, and ESRD developed in 410. The ESRD rate was 12.35 per 100,000 person-years in the preeclampsia group compared with 1.85 per 100,000 person-years in the no-preeclampsia group.
In adjusted analyses, women with preeclampsia had a significant 5-fold higher risk for ESRD than women who never had preeclampsia, Ali S. Khashan, PhD, of University College Cork in Ireland, and colleagues reported in PLOS One. Women with preeclampsia preterm, in 2 pregnancies, or with small gestational age, had a significant 9-, 7-, and 6-fold higher risk for ESRD, respectively.
Women diagnosed with chronic kidney disease (CKD), diabetes, hypertension, or cardiovascular disease before their first pregnancy were excluded from the study, so the excess risk from preeclampsia appears independent from these pre-existing conditions (although undiagnosed disease cannot be ruled out), according to the investigators. Analyses also adjusted for maternal age, body mass index (BMI), and smoking, among other factors.
ESRD in women with preeclampsia was associated mostly with development of interstitial nephritis and diabetic nephropathy, despite exclusion of diagnosed diabetes and adjustment for gestational diabetes and BMI.
“This shows that preeclampsia is a sex-specific, independent risk factor for the subsequent development of ESKD [end-stage kidney disease],” Dr Khashan and his team stated. “However, it should be noted that the overall ESKD risk remains small. Whether screening and/or preventative strategies will reduce the risk of ESKD in women with adverse pregnancy outcomes is worthy of further investigation.”
Khashan AS, Evans M, Kublickas M, et al. Preeclampsia and risk of end stage kidney disease: A Swedish nationwide cohort study. PLOS One. doi:10.1371/journal.pmed.1002875