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Abstract: TH-PO750

Preeclampsia and Long-Term Kidney Outcomes

Session Information

Category: Women's Health and Kidney Diseases

  • 2100 Women's Health and Kidney Diseases

Authors

  • Srialluri, Nityasree, Johns Hopkins University, Baltimore, Maryland, United States
  • Surapaneni, Aditya L., Johns Hopkins University, Baltimore, Maryland, United States
  • Chang, Alex R., Geisinger Health, Danville, Pennsylvania, United States
  • Grams, Morgan, Johns Hopkins University, Baltimore, Maryland, United States
Background

Preeclampsia is a complication of pregnancy characterized by acute hypertension and end-organ dysfunction. We aimed to evaluate the long-term association between preeclampsia and the risk of developing chronic hypertension and kidney disease.

Methods

We identified adult women without pre-existing hypertension or kidney disease who underwent deliveries in the Geisinger Health System between 1996- 2019 over a median follow up of 21 years. We used propensity-score matching to compare women who developed preeclampsia during pregnancy with women who did not. Cox proportional hazards models were used to evaluate the association between preeclampsia and incident hypertension, reduced estimated glomerular filtration rate (eGFR; <60 ml/min/1.73 m2), and albuminuria > 300mg/g.

Results

Of the 27800 women with pregnancies during the study period (mean [SD] age, 28[5.6] years; 3% black race), 2340 (8.4%) had at least one pregnancy complicated by preeclampsia. Women with preeclampsia had higher risk of developing chronic hypertension (HR, 1.72; 95% CI 1.41 - 2.11), eGFR < 60ml/min/1.73 m2 (HR 2.27; 1.26 - 4.09), and albuminuria (HR, 3.85; 95% CI 2.52 - 5.88), compared to matched controls without preeclampsia (Fig. 1). Additionally, the risk of a subsequent episode of preeclampsia was higher in women with preeclampsia compared to the matched controls (HR, 12.03; 95% CI 7.31 - 19.81).

Conclusion

Women with a pregnancy complicated by preeclampsia have a higher risk of hypertension, reduced eGFR, and albuminuria later in life compared to women without preeclampsia. Preeclampsia should be considered an important risk factor for hypertension and kidney disease. Further focus should be placed on implementing appropriate preventive strategies and vigilant post-partum follow-up in this population.

Kaplan Meier estimates of cumulative incidence of Hypertension, eGFR <60, and albuminuria among women with and without preeclampsia

Funding

  • NIDDK Support