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. 2013 Feb 19;185(3):207-13.
doi: 10.1503/cmaj.120230. Epub 2013 Jan 21.

Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study

I-Kuan Wang  1 , Chih-Hsin Muo, Yi-Chih Chang, Chih-Chia Liang, Chiz-Tzung Chang, Shih-Yi Lin, Tzung-Hai Yen, Feng-Rong Chuang, Pei-Chun Chen, Chiu-Ching Huang, Chi-Pang Wen, Fung-Chang Sung, Donald E Morisky
Affiliations

Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study

I-Kuan Wang et al. CMAJ. .

Abstract

Background: Studies into the association between hypertensive disorders during pregnancy and end-stage renal disease are limited. We investigated the risk of end-stage renal disease after delivery among women with hypertensive disorders during pregnancy.

Methods: We used insurance claims data from 1998 to 2009 to identify 26,651 women aged 19-40 years old who experienced hypertensive disorders during pregnancy; these women had no history of hypertension, diabetes, kidney disease or lupus. We also randomly selected 213,397 women without hypertensive disorders during pregnancy as a comparison cohort; the frequency was matched by age and index year of pregnancy. We compared the incidence of end-stage renal disease in the 2 cohorts. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) after controlling for demographic and clinical factors.

Results: Women with hypertensive disorders during pregnancy had a greater risk of chronic kidney disease and end-stage renal disease, with adjusted HRs of 9.38 (95% CI 7.09-12.4) and 12.4 (95% CI 8.54-18.0), respectively, after controlling for urban status, coronary artery disease, congestive heart failure, hyperlipidemia and abruption. The HR for end-stage renal disease was 2.72 (95% CI 1.76-4.22) after we also controlled for hypertension and diabetes. Women with preeclampsia or eclampsia had a higher risk of end-stage renal disease (adjusted HR 14.0, 95% CI 9.43-20.7) than women who had gestational hypertension only (adjusted HR 9.03, 95% CI 5.20-15.7).

Interpretation: Women with hypertensive disorders during pregnancy were at a high risk of end-stage renal disease. The risk was much greater for women who had preeclampsia or eclampsia than those who had gestational hypertension only.

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Figures

Figure 1:
Figure 1:
Estimated proportion of women without end-stage renal disease among those with and without hypertensive disorders during pregnancy. Log-rank test, p < 0.001.
See this image and copyright information in PMC

Comment in

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