Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study
- 21 January 2013
- journal article
- Published by CMA Impact Inc. in CMAJ : Canadian Medical Association Journal
- Vol. 185 (3), 207-213
- https://doi.org/10.1503/cmaj.120230
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.Keywords
This publication has 34 references indexed in Scilit:
- Population-based trends in pregnancy hypertension and pre-eclampsia: an international comparative studyBMJ Open, 2011
- Kidney Disease After Preeclampsia: A Systematic Review and Meta-analysisAmerican Journal of Kidney Diseases, 2010
- Excerpts From the US Renal Data System 2009 Annual Data ReportAmerican Journal of Kidney Diseases, 2010
- Hypertensive Pregnancy Disorders and Subsequent Cardiovascular Morbidity and Type 2 Diabetes Mellitus in the MotherHypertension, 2009
- Combining GFR and Albuminuria to Classify CKD Improves Prediction of ESRDJournal of the American Society of Nephrology, 2009
- Placental Origins of PreeclampsiaHypertension, 2008
- Short- and long-term prognosis of blood pressure and kidney disease in women with a past history of preeclampsiaClinical and Experimental Nephrology, 2008
- Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysisBMJ, 2007
- The health benefits of smoking cessation for adult smokers and for pregnant women in TaiwanTobacco Control, 2005
- Pregnancy outcomes in healthy nulliparas who developed hypertensionObstetrics & Gynecology, 2000