Kidney Week

Abstract: SA-OR010

Preeclampsia and Long-Term Risk of CKD: Global Cohort Study Using Real-World Data

Session Information

• CKD: Advancing Epidemiology, Risk Factors, and Prevention
  November 08, 2025 | Location: Room 362A, Convention Center
  Abstract Time: 04:30 PM - 04:40 PM

Category: Women's Health and Kidney Diseases

• 2200 Women's Health and Kidney Diseases

Authors

• Kaur, Gurwant, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Gurwant Kaur, MD, FASN

• Matarneh, Ahmad, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Ahmad Matarneh, MD

• Matarneh, Bayan, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Bayan Matarneh, MD

• Sardar, Sundus, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Sundus Sardar, MD

• Salameh, Omar Khaleel Mohammad, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Omar Khaleel Mohammad Salameh, MBBS

• Miller, Ronald P., Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Ronald P. Miller, MD

• Karasinski, Amanda A., Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Amanda A. Karasinski, MD

• Verma, Navin, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Navin Verma, MD

• Ghahramani, Nasrollah, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Nasrollah Ghahramani, MD, FASN

Background

Preeclampsia has been implicated in long-term cardiovascular and renal complications, but large-scale data quantifying its association with chronic kidney disease (CKD) are limited. We aimed to assess the incidence of moderate-to-severe CKD (stages 3–5) among women with a history of preeclampsia compared to those without.

Methods

Using the TriNetX Global Collaborative Network (148 healthcare organizations), we identified women aged 18–45 with documented pregnancies. Cohort A (n = 106,144) included patients with preeclampsia or pre-existing hypertension with superimposed preeclampsia; Cohort B (n = 2,139,255) included pregnant women without hypertensive complications. Outcomes were evaluated from one day post-index event through the available follow-up period. The primary outcome was incidence of CKD stages 3–5 (ICD-10: N18.3–N18.5). Secondary outcomes included mortality, acute kidney injury (AKI), end-stage renal disease (ESRD), nephrotic syndrome, and nephritis. Kaplan-Meier survival curves, risk ratios (RR), and hazard ratios (HR) were calculated.

Results

Compared to the control group, women with preeclampsia had significantly increased risk of CKD stages 3–5 (1.3% vs. 0.1%, RR 15.02; HR 16.31; p<0.001). Other renal complications were also more frequent in the preeclampsia group:
AKI: 2.7% vs. 0.5% (RR 5.58; HR 6.04)
ESRD: 0.8% vs. 0.1% (RR 15.44)
Nephrotic syndrome: 0.4% vs. 0.03% (RR 10.91; HR 11.15)
Nephritis: 0.6% vs. 0.1% (RR 10.41; HR 10.48)
Mortality: 0.6% vs. 0.2% (RR 2.43; HR 2.69)

Kaplan-Meier analysis confirmed significantly lower renal survival in the preeclampsia cohort. Median survival was not reached, but survival probability at end of follow-up was 92.5% for CKD-free survival vs. 98.6% in controls.
Conclusion

Conclusion

In this large, multicenter real-world cohort, preeclampsia was strongly associated with increased risks of CKD stages 3–5 and other serious renal outcomes. These findings underscore the need for long-term nephrology follow-up and risk-based screening protocols for women with a history of preeclampsia

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025hv5tvzr8