Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study

作者：Wang I Kuan; Muo Chih Hsin; Chang Yi Chih; Liang Chih Chia; Chang Chiz Tzung; Lin Shih Yi; Yen Tzung Hai; Chuang Feng Rong; Chen Pei Chun; Huang Chiu Ching; Wen Chi Pang; Sung Fung Chang^*; Morisky Donald E

来源：Canadian Medical Association Journal, 2013, 185(3): 207-213.

DOI：10.1503/cmaj.120230

Background: Studies into the association between hypertensive disorders during pregnancy and end-stage renal disease are limited. We investigated the risk of end-stage renal disease after delivery among women with hypertensive disorders during pregnancy. %26lt;br%26gt;Methods: We used insurance claims data from 1998 to 2009 to identify 26 651 women aged 19-40 years old who experienced hypertensive disorders during pregnancy; these women had no history of hypertension, diabetes, kidney disease or lupus. We also randomly selected 213 397 women without hypertensive disorders during pregnancy as a comparison cohort; the frequency was matched by age and index year of pregnancy. We compared the incidence of end-stage renal disease in the 2 cohorts. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) after controlling for demographic and clinical factors. %26lt;br%26gt;Results: Women with hypertensive disorders during pregnancy had a greater risk of chronic kidney disease and end-stage renal disease, with adjusted HRs of 9.38 (95% CI 7.09-12.4) and 12.4 (95% CI 8.54-18.0), respectively, after controlling for urban status, coronary artery disease, congestive heart failure, hyperlipidemia and abruption. The HR for end-stage renal disease was 2.72 (95% CI 1.76-4.22) after we also controlled for hypertension and diabetes. Women with preeclampsia or eclampsia had a higher risk of end-stage renal disease (adjusted HR 14.0, 95% CI 9.43-20.7) than women who had gestational hypertension only (adjusted HR 9.03, 95% CI 5.20-15.7). %26lt;br%26gt;Interpretation: Women with hypertensive disorders during pregnancy were at a high risk of end-stage renal disease. The risk was much greater for women who had preeclampsia or eclampsia than those who had gestational hypertension only.

• 出版日期2013-2-19
• 单位中国医科大学; 长春大学