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Preeclampsia and ESRD: The Role of Shared Risk Factors.


ABSTRACT: BACKGROUND:Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors. STUDY DESIGN:Population-based nested case-control study. SETTING & PARTICIPANTS:The US Renal Data System was used to identify women with ESRD from a cohort of 34,581 women who gave birth in 1976 to 2010 in Olmsted County, MN. 44 cases of ESRD were identified and each one was matched to 2 controls based on year of birth (±1 year), age at first pregnancy (±2 years), and parity (±1 or ?4). PREDICTOR:Preeclamptic pregnancy, confirmed by medical record review. OUTCOME:ESRD. MEASUREMENTS:Prepregnancy serum creatinine and urine protein measurements were recorded. Comorbid conditions existing prior to pregnancy were abstracted from medical records and included kidney disease, obesity, diabetes, and hypertension. RESULTS:There was evidence of kidney disease prior to the first pregnancy in 9 of 44 (21%) cases and 1 of 88 (<1%) controls. Per chart review, 8 of 44 (18%) cases versus 4 of 88 (5%) controls had preeclamptic pregnancies (unadjusted OR, 4.0; 95% CI, 1.21-13.28). Results were similar after independent adjustment for race, education, diabetes, and hypertension prior to pregnancy. However, the association was attenuated and no longer significant after adjustment for obesity (OR, 3.25; 95% CI, 0.93-11.37). LIMITATIONS:The limited number of ESRD cases and missing data for prepregnancy kidney function. CONCLUSIONS:Our findings confirm that there is a sizable association between preeclampsia and ESRD; however, obesity is a previously unexplored confounder. Pre-existing kidney disease was common, but not consistently coded or diagnosed.

SUBMITTER: Kattah AG 

PROVIDER: S-EPMC5366077 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Preeclampsia and ESRD: The Role of Shared Risk Factors.

Kattah Andrea G AG   Scantlebury Dawn C DC   Agarwal Sanket S   Mielke Michelle M MM   Rocca Walter A WA   Weaver Amy L AL   Vaughan Lisa E LE   Miller Virginia M VM   Weissgerber Tracey L TL   White Wendy W   Garovic Vesna D VD  

American journal of kidney diseases : the official journal of the National Kidney Foundation 20161001 4


<h4>Background</h4>Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors.<h4>Study design</h4>Population-based nested case-control s  ...[more]

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