Preeclampsia and Onset of Renal Disorders in the Long-Term Period following Pregnancy.

IF 3.2 3区 医学 Q1 UROLOGY & NEPHROLOGY
Sam Amar, Gilles Paradis, Aimina Ayoub, Antoine Lewin, Amanda Maniraho, Brian J Potter, Nathalie Auger
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Abstract

Introduction: Preeclampsia is associated with acute renal complications during pregnancy, but the risk of renal sequelae later in life is unclear. We determined if preeclampsia was associated with chronic renal complications in the long-term period following pregnancy.

Methods: We conducted a longitudinal cohort study of 1,431,156 pregnant women in QC, Canada with 25,598,024 person-years of follow-up between 1989 and 2023. The main exposure measure was preeclampsia, and outcomes included hospitalization for vascular and nonvascular renal complications up to 34 years after pregnancy. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between preeclampsia and subsequent kidney complications using Cox regression models adjusted for patient characteristics.

Results: Patients with preeclampsia had a higher hospitalization rate for renal complications than patients without preeclampsia (29.4 vs. 19.5 per 10,000 person-years). Preeclampsia was associated with 1.45 times the risk of hospitalization for renal disease during follow-up (95% CI 1.40-1.50). Risks were particularly elevated for renal vascular disease (HR 3.74, 95% CI 3.21-4.37), diabetic kidney disease (HR 3.71, 95% CI 3.18-4.32), and glomerulopathy (HR 3.44, 95% CI 2.92-4.05). Associations were also present with obstructive uropathy (HR 1.44, 95% CI 1.30-1.58). Severe forms of preeclampsia, including early onset preeclampsia (HR 1.90, 95% CI 1.72-2.10) and superimposed preeclampsia (HR 2.52, 95% CI 2.22-2.85), were strongly associated with subsequent renal morbidity.

Conclusion: Preeclampsia, especially severe preeclampsia, is associated with the long-term risk of renal disease. Patients with preeclampsia may benefit from nephrological follow-up in the long-term period after pregnancy.

子痫前期和长期妊娠后肾脏疾病的发病。
子痫前期与妊娠期急性肾脏并发症有关,但在以后的生活中是否有肾脏后遗症的风险尚不清楚。我们确定子痫前期是否与妊娠后长期的慢性肾脏并发症有关。方法:我们在1989年至2023年间对加拿大魁北克省的1,431,156名孕妇进行了一项纵向队列研究,随访25,598,024人年。主要暴露指标为先兆子痫,结果包括妊娠后34年因血管和非血管性肾脏并发症住院。我们使用经患者特征调整的Cox回归模型估计子痫前期与随后肾脏并发症之间关联的风险比(HR)和95%置信区间(CI)。结果:子痫前期患者的肾脏并发症住院率高于无子痫前期患者(29.4 vs 19.5 / 10000人年)。随访期间,先兆子痫患者因肾脏疾病住院的风险为1.45倍(95% CI 1.40-1.50)。肾血管疾病(HR 3.74, 95% CI 3.21-4.37)、糖尿病肾病(HR 3.71, 95% CI 3.18-4.32)和肾小球病变(HR 3.44, 95% CI 2.92-4.05)的风险特别高。梗阻性尿路病变也存在相关性(HR 1.44, 95% CI 1.30-1.58)。严重形式的先兆子痫,包括早发性先兆子痫(HR 1.90, 95% CI 1.72-2.10)和叠加性先兆子痫(HR 2.52, 95% CI 2.22-2.85)与随后的肾脏发病率密切相关。结论:子痫前期,尤其是重度子痫前期,与肾脏疾病的长期风险相关。子痫前期患者可能受益于妊娠后长期的肾病随访。
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来源期刊
American Journal of Nephrology
American Journal of Nephrology 医学-泌尿学与肾脏学
CiteScore
7.50
自引率
2.40%
发文量
74
审稿时长
4-8 weeks
期刊介绍: The ''American Journal of Nephrology'' is a peer-reviewed journal that focuses on timely topics in both basic science and clinical research. Papers are divided into several sections, including:
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