Preeclampsia after Kidney Transplantation: Rates and Association with Graft Survival and Function

Area of Science:

• Nephrology
• Obstetrics
• Transplant Surgery

Background:

• Kidney transplant recipients have high rates of preeclampsia.
• The impact of preeclampsia on graft survival and function remains unclear.

Purpose of the Study:

• To determine the incidence of preeclampsia in pregnancies post-kidney transplant.
• To investigate the association between preeclampsia and kidney transplant graft survival and function.

Main Methods:

• Retrospective cohort study of post-kidney transplant pregnancies (2000-2021) from the Australia and New Zealand Dialysis and Transplant Registry.
• Graft survival analyzed using three models, accounting for repeated pregnancies and preeclampsia episodes.

Main Results:

• Preeclampsia occurred in 37% of pregnancies, with incidence rising over time.
• Preeclampsia was not associated with increased death-censored graft failure.
• Preconception kidney function (eGFR <45 ml/min/1.73 m² or serum creatinine ≥1.24 mg/dl) was strongly associated with higher graft failure risk.

Conclusions:

• Preeclampsia does not appear to negatively impact kidney graft survival or function.
• Preconception kidney function is the primary determinant of long-term graft survival post-transplant.