Hannah R Cutler, Jamie Kitt, Prenali D Sattwika, Lucy E M Finnigan, Ana Estevez-Fernandez, Yvonne Kenworthy, Katie Suriano, Annabelle Frost, Samuel Krasner, Casey Johnson, Annabelle McCourt, Rebecca Mills, Katherine Tucker, Alexandra Cairns, Cristian Roman, Christina Aye, Lucy Mackillop, Basky Thilaganathan, Lucy C Chappell, Betty Raman, Adam J Lewandowski, Winok Lapidaire, Paul Leeson
{"title":"高血压妊娠障碍后的亚临床产后肾脏结构。","authors":"Hannah R Cutler, Jamie Kitt, Prenali D Sattwika, Lucy E M Finnigan, Ana Estevez-Fernandez, Yvonne Kenworthy, Katie Suriano, Annabelle Frost, Samuel Krasner, Casey Johnson, Annabelle McCourt, Rebecca Mills, Katherine Tucker, Alexandra Cairns, Cristian Roman, Christina Aye, Lucy Mackillop, Basky Thilaganathan, Lucy C Chappell, Betty Raman, Adam J Lewandowski, Winok Lapidaire, Paul Leeson","doi":"10.1161/HYPERTENSIONAHA.125.25130","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hypertensive pregnancies are associated with increased risks of renal failure in pregnancy and later life. However, traditional markers of renal function normalize postpartum, making identification of those at future disease risk difficult. We studied whether the type and severity of hypertensive pregnancy associated with postpartum renal structure.</p><p><strong>Methods: </strong>One hundred twenty-five women from interventional trials (61 preeclamptic, 33 gestational hypertension, and 31 normotensive pregnancy), aged ≥18 years, were imaged using magnetic resonance imaging 6 to 12 months postpartum. Anthropometric, demographic, blood pressure, and blood sample data were collected during pregnancy and postpartum. Kidney volume indexed to body surface area and corticomedullary differentiation were compared between groups using a 1-way ANCOVA, whereas associations with other outcomes were assessed using correlation tests.</p><p><strong>Results: </strong>Postpartum total kidney volume indexed to body surface area was smaller in women who had preeclampsia compared with those who had gestational hypertension or a normotensive pregnancy (<i>P</i>=0.049). Total kidney volume postpartum correlated with estimated glomerular filtration rate at delivery (<i>P</i><0.001). However, smaller volumes were not explained by reduced corticomedullary differentiation, which only differed in women with gestational hypertension compared with preeclamptic (<i>P</i>=0.02) and normotensive women (<i>P</i>=0.007). There were no associations between renal measures and blood pressure during or after pregnancy.</p><p><strong>Conclusions: </strong>At 6 to 12 months postpartum, preeclamptic women have smaller kidney volumes than women with gestational hypertension or normotensive pregnancies. These smaller volumes relate to lower renal function at delivery but not corticomedullary differentiation, which only differed in women with gestational hypertension.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifiers: NCT04273854 and NCT05434195.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":8.2000,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Subclinical Postpartum Renal Structure After Hypertensive Pregnancy Disorders.\",\"authors\":\"Hannah R Cutler, Jamie Kitt, Prenali D Sattwika, Lucy E M Finnigan, Ana Estevez-Fernandez, Yvonne Kenworthy, Katie Suriano, Annabelle Frost, Samuel Krasner, Casey Johnson, Annabelle McCourt, Rebecca Mills, Katherine Tucker, Alexandra Cairns, Cristian Roman, Christina Aye, Lucy Mackillop, Basky Thilaganathan, Lucy C Chappell, Betty Raman, Adam J Lewandowski, Winok Lapidaire, Paul Leeson\",\"doi\":\"10.1161/HYPERTENSIONAHA.125.25130\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hypertensive pregnancies are associated with increased risks of renal failure in pregnancy and later life. However, traditional markers of renal function normalize postpartum, making identification of those at future disease risk difficult. We studied whether the type and severity of hypertensive pregnancy associated with postpartum renal structure.</p><p><strong>Methods: </strong>One hundred twenty-five women from interventional trials (61 preeclamptic, 33 gestational hypertension, and 31 normotensive pregnancy), aged ≥18 years, were imaged using magnetic resonance imaging 6 to 12 months postpartum. Anthropometric, demographic, blood pressure, and blood sample data were collected during pregnancy and postpartum. Kidney volume indexed to body surface area and corticomedullary differentiation were compared between groups using a 1-way ANCOVA, whereas associations with other outcomes were assessed using correlation tests.</p><p><strong>Results: </strong>Postpartum total kidney volume indexed to body surface area was smaller in women who had preeclampsia compared with those who had gestational hypertension or a normotensive pregnancy (<i>P</i>=0.049). Total kidney volume postpartum correlated with estimated glomerular filtration rate at delivery (<i>P</i><0.001). However, smaller volumes were not explained by reduced corticomedullary differentiation, which only differed in women with gestational hypertension compared with preeclamptic (<i>P</i>=0.02) and normotensive women (<i>P</i>=0.007). There were no associations between renal measures and blood pressure during or after pregnancy.</p><p><strong>Conclusions: </strong>At 6 to 12 months postpartum, preeclamptic women have smaller kidney volumes than women with gestational hypertension or normotensive pregnancies. These smaller volumes relate to lower renal function at delivery but not corticomedullary differentiation, which only differed in women with gestational hypertension.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifiers: NCT04273854 and NCT05434195.</p>\",\"PeriodicalId\":13042,\"journal\":{\"name\":\"Hypertension\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":8.2000,\"publicationDate\":\"2025-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hypertension\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1161/HYPERTENSIONAHA.125.25130\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hypertension","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/HYPERTENSIONAHA.125.25130","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Subclinical Postpartum Renal Structure After Hypertensive Pregnancy Disorders.
Background: Hypertensive pregnancies are associated with increased risks of renal failure in pregnancy and later life. However, traditional markers of renal function normalize postpartum, making identification of those at future disease risk difficult. We studied whether the type and severity of hypertensive pregnancy associated with postpartum renal structure.
Methods: One hundred twenty-five women from interventional trials (61 preeclamptic, 33 gestational hypertension, and 31 normotensive pregnancy), aged ≥18 years, were imaged using magnetic resonance imaging 6 to 12 months postpartum. Anthropometric, demographic, blood pressure, and blood sample data were collected during pregnancy and postpartum. Kidney volume indexed to body surface area and corticomedullary differentiation were compared between groups using a 1-way ANCOVA, whereas associations with other outcomes were assessed using correlation tests.
Results: Postpartum total kidney volume indexed to body surface area was smaller in women who had preeclampsia compared with those who had gestational hypertension or a normotensive pregnancy (P=0.049). Total kidney volume postpartum correlated with estimated glomerular filtration rate at delivery (P<0.001). However, smaller volumes were not explained by reduced corticomedullary differentiation, which only differed in women with gestational hypertension compared with preeclamptic (P=0.02) and normotensive women (P=0.007). There were no associations between renal measures and blood pressure during or after pregnancy.
Conclusions: At 6 to 12 months postpartum, preeclamptic women have smaller kidney volumes than women with gestational hypertension or normotensive pregnancies. These smaller volumes relate to lower renal function at delivery but not corticomedullary differentiation, which only differed in women with gestational hypertension.
Registration: URL: https://www.clinicaltrials.gov; Unique identifiers: NCT04273854 and NCT05434195.
期刊介绍：
Hypertension presents top-tier articles on high blood pressure in each monthly release. These articles delve into basic science, clinical treatment, and prevention of hypertension and associated cardiovascular, metabolic, and renal conditions. Renowned for their lasting significance, these papers contribute to advancing our understanding and management of hypertension-related issues.
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