Association Between Hypertensive Disorders During Pregnancy and the Subsequent Risk of End-Stage Renal Disease: A Population-Based Follow-Up Study

Dai, Li; Chen, Yue; Sun, Wen; Liu, Shiliang

doi:10.1016/j.jogc.2018.01.022

Cited by 25 publications

(41 citation statements)

References 28 publications

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“…However, most studies in this systematic review reported strong associations even after controlling for, or excluding, women with prepregnancy hypertension 8,9,[27][28][29][30][31][35][36][37][38][39] or obesity. 28,32,33,35,39,42 Preeclampsia has been proposed as a cause of lasting vascular endothelial dysfunction, possibly associated with elevated levels of soluble fms-like tyrosine kinase-1, an antiangiogenic protein…”

Section: Discussionmentioning

confidence: 69%

“…8,9, Detailed characteristics of the 18 articles that provided effect estimates for HDP and maternal kidney disease are presented in Table 2. 8,9,[27][28][29][30][31][32][33][34][35][36][37][38][39]42,[46][47][48] The data relating to preterm birth are presented in eTable 1 in the Supplement, data relating to delivery of low-birth-weight (or small for gestational age) infants are presented in eTable 2 in the Supplement, and data relating to GDM are presented in eTable 3 in the Supplement. Nine studies provided effect estimates for any HDP and ESKD.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies provided effect estimates for any HDP and ESKD. 8,[27][28][29][30][31]37,38 Four of these studies were excluded from the meta-analysis, either owing to overlap of study populations or because they were restricted to women with higher baseline risk of ESKD. [29][30][31]38 All the remaining studies provided adjusted effect estimates for preeclampsia and ESKD, of which 2 also provided adjusted estimates for gestational hypertension, chronic hypertension, and PSH in mutually exclusive groups.…”

Section: Resultsmentioning

confidence: 99%

“…None of these studies considered whether preterm delivery was spontaneous or obstetrically indicated, although they had adjusted for preeclampsia. 8,28,29 Pariente et al 43 reported that the risk of kidney-related hospitalization was independently increased among Israeli women with preterm delivery, of whom most (70%) had spontaneous preterm delivery. When their analysis was restricted to those with indicated preterm delivery, no significant difference in kidney-related hospitalization was observed.…”

Section: Discussionmentioning

confidence: 99%

“…Third, existing literature suggests that delivery of infants with low birth weight or who are small for gestational age may be associated with increased risk of maternal kidney disease. 8,28,41 However, there is a paucity of research examining this association, and only 1 of these studies controlled for maternal preeclampsia. 8 It is possible that the apparent associations are confounded by unmeasured placental factors.…”

Section: Discussionmentioning

confidence: 99%

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Adverse Pregnancy Outcomes and Long-term Maternal Kidney Disease

et al. 2020

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IMPORTANCE Adverse pregnancy outcomes, such as hypertensive disorders of pregnancy, gestational diabetes, and preterm delivery, are associated with increased risk of maternal cardiovascular disease. Little is known about whether adverse pregnancy outcomes are associated with increased risk of maternal chronic kidney disease (CKD) and end-stage kidney disease (ESKD). OBJECTIVE To review and synthesize the published literature on adverse pregnancy outcomes (hypertensive disorders of pregnancy, gestational diabetes, and preterm delivery) and subsequent maternal CKD and ESKD. DATA SOURCES PubMed, Embase, and Web of Science were searched from inception to July 31, 2019, for cohort and case-control studies of adverse pregnancy outcomes and maternal CKD and ESKD. STUDY SELECTION Selected studies included the following: a population of pregnant women, exposure to an adverse pregnancy outcome of interest, and at least 1 primary outcome (CKD or ESKD) or secondary outcome (hospitalization or death due to kidney disease). Adverse pregnancy outcomes included exposure to hypertensive disorders of pregnancy (preeclampsia, gestational hypertension, or chronic hypertension), preterm delivery (<37 weeks), and gestational diabetes. Three reviewers were involved in study selection. Of 5656 studies retrieved, 23 were eligible for inclusion. DATA EXTRACTION AND SYNTHESIS The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines were followed throughout. Three reviewers extracted data and appraised study quality. Random-effects meta-analyses were used to calculate overall pooled estimates using the generic inverse variance method. MAIN OUTCOMES AND MEASURES Primary outcomes included CKD and ESKD diagnosis, defined using established clinical criteria (estimated glomerular filtration rate or albuminuria values) or hospital records. The protocol for this systematic review was registered on PROSPERO (CRD42018110891). RESULTS Of 23 studies included (5 769 891 participants), 5 studies reported effect estimates for more than 1 adverse pregnancy outcome. Preeclampsia was associated with significantly increased risk of CKD (pooled adjusted risk ratio [aRR], 2.11; 95% CI, 1.72-2.59), ESKD (aRR, 4.90; 95% CI, 3.56-6.74), and kidney-related hospitalization (aRR, 2.65; 95% CI, 1.03-6.77). Gestational hypertension was associated with increased risk of CKD (aRR, 1.49; 95% CI, 1.11-2.01) and ESKD (aRR, 3.64; 95% CI, 2.34-5.66). Preterm preeclampsia was associated with increased risk of ESKD (aRR, 5.66; 95% CI, 3.06-10.48); this association with ESKD persisted for women who had preterm (continued) Key Points Question Are adverse pregnancy outcomes associated with risk of longterm kidney disease in women? Findings In this systematic review and meta-analysis of 23 studies (5 769 891 participants), the risk of end-stage kidney disease was 4.9 times higher in women who had preeclampsia, and 3.6 times higher in women who had gestational hypertension vs women with normotensive pregnancies. The risk of end-stage kidney disease was 2.1 time...

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Section: Discussionmentioning

confidence: 69%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Adverse Pregnancy Outcomes and Long-term Maternal Kidney Disease

et al. 2020

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Maternal Microvascular Dysfunction During and After Preeclamptic Pregnancy

Schwartz,

Stanhewicz

2024

Comprehensive Physiology

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Preeclampsia, a pregnancy disorder characterized by de novo hypertension and maternal multisystem organ dysfunction, is the leading cause of maternal mortality worldwide and is associated with a fourfold greater risk of cardiovascular disease throughout the lifespan. Current understanding of the etiology of preeclampsia remains unclear, due in part to the varying phenotypical presentations of the disease, which has hindered the development of effective and mechanism‐specific treatment or prevention strategies both during and after the affected pregnancy. These maternal sequelae of preeclampsia are symptoms of systemic vascular dysfunction in the maternal nonreproductive microvascular beds that drives the development and progression of adverse cardiovascular outcomes during preeclampsia. Despite normalization of vascular disturbances after delivery, subclinical dysfunction persists in the nonreproductive microvascular beds, contributing to an increased lifetime risk of cardiovascular and metabolic diseases and all‐cause mortality. Given that women with a history of preeclampsia demonstrate vascular dysfunction despite an absence of traditional CVD risk factors, an understanding of the underlying mechanisms of microvascular dysfunction during and after preeclampsia is essential to identify potential therapeutic avenues to mitigate or reverse the development of overt disease. This article aims to provide a summary of the existing literature on the pathophysiology of maternal microvascular dysfunction during preeclampsia, the mechanisms underlying the residual dysfunction that remains after delivery, and current and potential treatments both during and after the affected pregnancy that may reduce microvascular dysfunction in these high‐risk women. © 2024 American Physiological Society. Compr Physiol 14:5703‐5727, 2024.

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Cardiovascular events following pregnancy complicated by pre‐eclampsia with emphasis on comparison between early‐ and late‐onset forms: systematic review and meta‐analysis

Dall’Asta

D’Antonio

Saccone

et al. 2021

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?Based on the results of this meta-analysis, both early-and late-onset pre-eclampsia (PE) represent risk factors for maternal cardiovascular morbidity and mortality later in life; however, early-onset PE is associated with a higher risk of long-term adverse cardiovascular events compared to late-onset PE. What are the clinical implications of this work?Close surveillance of women with a history of PE is recommended, particularly for those who developed an early-onset form which may act as an isolated major risk factor of cardiovascular events. In cases with previous late-onset PE, lifestyle or medical interventions targeting the modifiable risk factors for adverse cardiovascular health are warranted.

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Association Between Hypertensive Disorders During Pregnancy and the Subsequent Risk of End-Stage Renal Disease: A Population-Based Follow-Up Study

Cited by 25 publications

References 28 publications

Adverse Pregnancy Outcomes and Long-term Maternal Kidney Disease

Adverse Pregnancy Outcomes and Long-term Maternal Kidney Disease

Maternal Microvascular Dysfunction During and After Preeclamptic Pregnancy

Cardiovascular events following pregnancy complicated by pre‐eclampsia with emphasis on comparison between early‐ and late‐onset forms: systematic review and meta‐analysis

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