Preeclampsia and Long-term Kidney Outcomes: An Observational Cohort Study.

Area of Science:

• Obstetrics and Gynecology
• Nephrology
• Cardiology

Background:

• Preeclampsia is a serious pregnancy complication causing hypertension and end-organ damage.
• Long-term effects of preeclampsia on chronic hypertension and kidney disease are not fully understood.
• Assessing postpartum health outcomes and monitoring rates is crucial for managing preeclampsia's sequelae.

Purpose of the Study:

• To evaluate the long-term association between preeclampsia and the risk of developing chronic hypertension.
• To assess the risk of chronic kidney disease, indicated by reduced estimated glomerular filtration rate (eGFR) and albuminuria, following preeclampsia.
• To examine postpartum follow-up testing rates for individuals with and without a history of preeclampsia.

Main Methods:

• An observational cohort study involving 27,800 adults with deliveries between 1996 and 2019.
• Propensity-score matching was used to compare individuals with and without preeclampsia.
• Cox proportional hazards models analyzed the association between preeclampsia and incident hypertension, reduced eGFR, and albuminuria.

Main Results:

• Individuals with preeclampsia had a significantly higher risk of developing chronic hypertension (HR, 1.77).
• Preeclampsia was associated with increased risks of reduced eGFR (HR, 3.23) and albuminuria (HR, 3.60).
• Postpartum follow-up testing rates for serum creatinine and urine protein were low in both groups, with slightly higher rates in the preeclampsia group.

Conclusions:

• Preeclampsia is a significant risk factor for the development of chronic hypertension and chronic kidney disease.
• The findings underscore the need for enhanced postpartum surveillance and monitoring strategies for individuals with a history of preeclampsia.
• Low postpartum testing rates indicate a need for improved adherence to follow-up protocols to detect and manage long-term complications.