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Reduced renal function after preeclampsia does not result from accelerated age-dependent renal function loss.

Julia J Spaan¹, Timo Ekhart, Marc E A Spaanderman

¹Department of Obstetrics and Gynecology, Maastricht University Medical Center, The Netherlands. julia.spaan@maastrichtuniversity.nl

Acta Obstetricia Et Gynecologica Scandinavica

|June 8, 2010

Summary

Formerly preeclamptic women exhibit reduced kidney function, not accelerated aging of renal function. This persistent lower renal function, evident even in younger women, suggests preeclampsia may lead to lasting kidney changes.

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Area of Science:

Nephrology
Obstetrics
Gerontology

Background:

Preeclampsia is a pregnancy complication linked to an increased risk of developing kidney disease later in life.
The long-term effects of preeclampsia on renal function decline with aging are not fully understood.

Purpose of the Study:

To investigate whether the age-related decline in renal function is accelerated in women with a history of preeclampsia compared to controls.
To determine if reduced renal function observed in formerly preeclamptic women is due to faster aging or a baseline deficit.

Main Methods:

Cross-sectional comparison of four groups: young and middle-aged women with and without a history of preeclampsia.
Measurements included blood pressure, effective renal plasma flow (ERPF) via para-aminohippurate clearance, glomerular filtration rate (GFR) via creatinine clearance, and cardiac output using Doppler echocardiography.

Main Results:

Effective renal plasma flow (ERPF) was significantly lower in both young and middle-aged formerly preeclamptic women compared to their respective control groups.
The rate of decline in both GFR and ERPF with increasing age was similar between the preeclampsia and control groups.
Women with a history of preeclampsia showed reduced renal function at a younger age, which persisted into middle age.

Conclusions:

The diminished renal function in middle-aged formerly preeclamptic women is not caused by an accelerated loss of kidney function over time.
Reduced renal function in this group appears to stem from a pre-existing deficit present from a younger age, relative to parous controls.