Preeclampsia and the Risk of End-Stage Renal Disease

Vikse, Bjørn Egil; Irgens, Lorentz M.; Leivestad, Torbjørn; Skjærven, Rolv; Iversen, Bjarne M.

doi:10.1056/nejmoa0706790

Cited by 578 publications

(301 citation statements)

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“…[97][98][99][100] Recently, the American Heart Association has recognized preeclampsia as a novel risk factor for CVD in women. 101 It is currently thought that the background metabolic milieu of women (ie, shared risk factors) confer risk for both preeclampsia and for long-term CVD.…”

Section: Long-term Complications Of Preeclampsiamentioning

confidence: 99%

Angiogenic Factors in Preeclampsia

2016

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Section: Long-term Complications Of Preeclampsiamentioning

confidence: 99%

Angiogenic Factors in Preeclampsia

2016

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“…44 In addition, we have no reliable data available on total number of PE pregnancy to study the effect of repetitive PE on eGFR while other studies already showed a dose-response curve on cardiovascular and renal prognosis. 3,35 Other limitations are the slight differences in pregnancy to follow-up interval between the fHP and fPE groups, the absence of urinary albumin measurement, and the absence of data on social economic status, which is correlated with a lower eGFR. 45 In a subgroup of the PREVFEM cohort, it was suggested that the fPE might have a higher social economic status because they were reported to have a higher education, 46 but in the full cohort, we could not find any differences in modifiable indicators of socioeconomic status affecting the eGFR (BMI and metabolic profile).…”

Section: -24mentioning

confidence: 99%

“…1,2 In addition, they are reported to have a 5-to 12-fold increased risk to develop end-stage kidney disease (ESKD) in studies with follow-up times ranging from 6 to 17 years postpartum. [3][4][5] The risk of chronic kidney disease (CKD) is estimated to be increased 4 to 10 times. 4 The exact course of renal function after preeclampsia that precedes the development of CKD and ESKD remains unclear and hinders the development of strategies to earlier identify the women at highest risk.…”

mentioning

confidence: 99%

High-Normal Estimated Glomerular Filtration Rate in Early-Onset Preeclamptic Women 10 Years Postpartum

et al. 2016

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Abstract-Women with a history of preeclampsia have a 5-to 12-fold increased risk to develop end-stage kidney disease.Previous observations in small cohorts suggest that former preeclamptic (fPE) women have subtle abnormalities in renal hemodynamics and renal function, which might predispose them to renal failure in later life. In this study, we analyzed renal function in a cross-sectional cohort consisting of former early-onset preeclamptic (fPE, n=339) and former healthy pregnant women (fHP, n=332), overall with a mean age of 39 years at 10 years postpartum. Estimated glomerular filtration rate (eGFR), assessed by the modification of diet in renal disease (MDRD) and chronic kidney disease-epidemiology (CKD-epi) equations, and urinary protein:creatinine ratios were assessed 10 years postpartum. Median MDRD and CKD-epi eGFR did not significantly differ between fHP and fPE groups, whereas a comparison of distribution of eGFR revealed a shift toward a high-normal MDRD eGFR in the fPE group (χ 2 , P=0.02) with the same trend for CKD-epi eGFR (χ 2 , P=0.18). The odds ratio for fPE women having MDRD eGFR >110 mL/min per 1.73 m 2 was 1.6 (1.1-2.4). In addition, the median urinary protein:creatinine ratio was slightly higher in fPE (8.5 versus 7.1 mg/mmol; P<0.01) and correlated positively with both MDRD and CKD-epi eGFR in fPE women. No increased incidence of CKD in fPE women was observed.In conclusion, we demonstrate subtle changes in renal function in former early-onset preeclamptic women 10 years postpartum, characterized by a high-normal eGFR and a slightly higher protein excretion. Whether these subtle differences predispose to or predict long-term renal function loss in fPE women remains to be investigated. Clinical Trial Registration-URL: http://www.trialregister.nl. Unique identifier: NTR2668.

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“…However, long-term renal and cardiovascular risks have been associated with a history of maternal placental syndromes such as PE, suggesting that PE is more than an isolated disease of pregnancy (3). Increased risk of developing future chronic hypertension and CVD has been observed in women diagnosed with PE during pregnancy compared with normotensive women (4)(5)(6). While the American Heart Association guidelines in 2011 recognized PE as cardiovascular risk factor (7), it is unknown whether the increased risk can be attributed to factors that develop during pregnancy or to prepregnancy predisposing factors that Preeclampsia (PE), associates with long-term increased risk for cardiovascular disease in women, suggesting that PE is not an isolated disease of pregnancy.…”

Section: Introductionmentioning

confidence: 99%