Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study
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.
See related commentary by Spaan and Brown on page 199 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.130007
In this issue
Article tools
Jump to section
Related Articles
Cited By...
- Updates in Diagnosis and Management of Preeclampsia in Women with CKD
- Pre-eclampsia and risk of later kidney disease: nationwide cohort study
- ESRD among Immigrants to Ontario, Canada: A Population-Based Study
- High-Normal Estimated Glomerular Filtration Rate in Early-Onset Preeclamptic Women 10 Years Postpartum
- Long-term renal and cardiovascular risk after preeclampsia: towards screening and prevention
- Molecular Mechanisms of Preeclampsia
- Hypertension during pregnancy is associated with increased risk of chronic and end-stage kidney disease
- Hypertensive disorders of pregnancy predict chronic kidney disease and end-stage renal disease
- Can we protect the kidneys after hypertensive pregnancy?