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End stage kidney disease

Pre-eclampsia increases ESKD risk

Women with pre-eclampsia during pregnancy have a five-fold increased risk of end stage kidney disease (ESKD) later in life compared to women who don’t develop pre-eclampsia during pregnancy, according to a new study.

Professor Louise Kenny from the University of Liverpool is one of the co-authors of the study, which is published in PLOS Medicine and also involved researchers at University College Cork and the Karolinska Institute. As the prevalence of kidney disease has risen over recent years, it has become clear that more women have pre-dialysis kidney disease than men. Reproductive history, including the development of pre-eclampsia during pregnancy, has been hypothesized to play a role. In the new study, researchers analysed data from the Swedish Medical Birth Register on 1,366,441 healthy women with 2,665,320 singleton live births in Sweden between 1982 and 2012.

Given the burden of disease end stage kidney disease has in our increasingly aging population, this is an important public health issue

Louise Kenny

The data revealed that women who had pre-eclampsia in at least one pregnancy were nearly five times more likely to have ESKD than women who had never had pre-eclampsia. The incidence rate of ESKD per 100,000 person-years was 1.85 among women with no history of pre-eclampsia and 12.35 among women with a history of pre-eclampsia. Moreover, the association was independent of other factors including maternal age and education, and diagnoses of renal disease or cardiovascular disease before pregnancy.

The new paper “shows that pre-eclampsia is a sex-specific, independent risk factor for the subsequent development of ESKD,” the authors say. “However, it should be noted that the overall ESKD risk remains small. Whether screening or preventative strategies will reduce the risk of ESKD in women with adverse pregnancy outcomes is worthy of further investigation.” Professor Kenny adds: “This work shows a significant link between pre-eclampsia and end stage kidney disease. Given the burden of disease end stage kidney disease has in our increasingly aging population, this is an important public health issue and further research is needed to clarify the role for using pregnancy outcome in screening tests.”


Source: University of Liverpool

01.08.2019

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