Preeclampsia tied to increased risk for renal failure

  • Khashan AS & al.
  • PLoS Med
  • 1 Jul 2019

  • International Clinical Digest
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Takeaway

  • Women with preeclampsia have a 5-fold higher risk for later end-stage renal disease (ESRD) compared with women who have never had preeclampsia.

Why this matters

  • Earlier stages of renal disease are more common in women than men. 
  • Reproductive history, including preeclampsia, is hypothesized to play a role.
  • Benefit of screening and prevention for reducing ESRD risk is worth more investigation, the authors say, noting the overall low risk.

Study design

  • Study of 1,366,441 healthy women with 2,665,320 live singleton births, 1982-2012, Sweden.
  • Mean age at first pregnancy: 27.8±5.13 years; mean BMI: 23.4±4.03 kg/m2.
  • Median follow-up: 7.4 years overall; 16.4 years for women with ESRD.
  • Funding: Irish Center for Fetal and Neonatal Translational Research; Swedish Kidney Foundation; others.

Key results

  • 67,273 women (4.9%) had preeclampsia; 410 developed ESRD.
  • Incidence rate was higher among women with vs without preeclampsia: 12.35 vs 1.85 per 100,000 person-years.
  • Preeclampsia was tied to a 5-fold risk for ESRD vs no preeclampsia (adjusted [a]HR, 4.96; P<.001 for age bmi smoking other factors>
  • Risk for ESRD was highest with:
    • Preterm preeclampsia: aHR, 9.19 (P<.001>
    • Preeclampsia in 2 pregnancies: aHR, 7.13 (P<.001>
  • Highest risk seen with diabetic nephropathy (HR, 9.60; P<.001 interstitial nephritis>

Limitations

  • Observational design.

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