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Am J Obstet Gynecol. 2014 Feb;210(2):147.e1-8. doi: 10.1016/j.ajog.2013.09.027. Epub 2013 Sep 20.

End-stage renal disease after hypertensive disorders in pregnancy.

Author information

  • 1Department of Nephrology, Chi Mei Medical Center, Tainan, Taiwan; Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
  • 2Department of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan; DA-AN Women and Children's Hospital, Tainan, Taiwan.
  • 3Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
  • 4Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • 5Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan; Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
  • 6Department of Nephrology, Chi Mei Medical Center, Tainan, Taiwan; Department of Sports Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
  • 7Department of Nephrology, Chi Mei Medical Center, Tainan, Taiwan.

Abstract

OBJECTIVE:

The purpose of this study was to determine the long-term postpartum risk of end-stage renal disease in women with hypertensive disorders in pregnancy. Although most women with hypertensive disorders in pregnancy recover after delivery, some may experience acute renal failure.

STUDY DESIGN:

We searched Taiwan's National Health Insurance Research Database to identify women with hypertensive disorders in pregnancies and deliveries between 1998 and 2002. All cases were followed for a maximum of 11 years (median, 9 years; interquartile range, 7.79-10.02 years) to estimate the incidence of end-stage renal disease; Cox regression analysis that was adjusted for potential confounding was used to determine the relative risk.

RESULTS:

Of the 13,633 women with hypertensive disorders in pregnancy, 46 experienced end-stage renal disease. Women with hypertensive disorders in pregnancy had a risk of end-stage renal disease that was 10.64 times greater than did women without them (95% confidence interval [CI], 7.53-15.05). The risk was highest in women with a history of preeclampsia superimposed on chronic hypertension (hazard ratio, 44.72; 95% CI, 22.59-88.51). Women with gestational hypertension had a higher risk of end-stage renal disease than did women without hypertensive disorders in pregnancy (hazard ratio, 5.82; 95% CI, 2.15-15.77).

CONCLUSION:

Women with hypertensive disorders in pregnancy have a higher risk of postpartum end-stage renal disease, regardless of which type of hypertensive disorder they have. Women with a history of hypertensive disorders in pregnancy are encouraged to have regular postpartum checkups, especially of renal function.

Copyright © 2014 Mosby, Inc. All rights reserved.

KEYWORDS:

hypertensive disorder; renal disease

PMID:
24060448
[PubMed - indexed for MEDLINE]
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