RT Journal Article
SR Electronic
T1 Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP cmaj.120230
DO 10.1503/cmaj.120230
A1 I-Kuan Wang
A1 Chih-Hsin Muo
A1 Yi-Chih Chang
A1 JChih-Chia Liang
A1 Chiz-Tzung Chang
A1 Shih-Yi Lin
A1 Tzung-Hai Yen
A1 Feng-Rong Chuang
A1 Pei-Chun Chen
A1 Chiu-Ching Huang
A1 Chi-Pang Wen
A1 Fung-Chang Sung
A1 Donald E. Morisky
YR 2013
UL http://www.cmaj.ca/content/early/2013/01/21/cmaj.120230.abstract
AB 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.