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Impact of Preeclampsia on Long-Term Kidney Function in a Low-Resourced Setting
Bianca Davidson1, Kate Bramham2, Kathryn Manning3
1Division of Nephrology and Hypertension, Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa.
Kidney International Reports
|January 8, 2026
Summary
Preeclampsia leads to common long-term hypertension and kidney issues, especially in women with pregnancy-related acute kidney injury (Pr-AKI). Integrated postpartum surveillance is crucial for managing these cardio-renal sequelae.
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Cardiology
Background:
- Hypertensive disorders of pregnancy (HDPs) affect 10% of pregnancies globally, with higher risks in low- and middle-income countries.
- Long-term cardiovascular and kidney complications post-preeclampsia are known in high-income settings, but data from LMICs are limited.
- This study investigates persistent hypertension, kidney dysfunction, and albuminuria after preeclampsia in a South African cohort.
Purpose of the Study:
- To assess the incidence and persistence of hypertension, reduced estimated glomerular filtration rate (eGFR), and albuminuria following preeclampsia.
- To identify risk factors associated with these long-term cardio-renal sequelae.
- To highlight the need for postpartum surveillance in preeclampsia survivors.
Main Methods:
- Prospective cohort study at Groote Schuur Hospital, South Africa (2020-2024).
- Collected clinical, demographic, and biochemical data at delivery and 1- and 2-year follow-ups.
- Used logistic regression to analyze predictors of hypertension, reduced eGFR, and albuminuria.
Main Results:
- Persistent hypertension was observed in 44-47% of women up to 2 years post-delivery.
- Reduced eGFR (< 90 ml/min/1.73 m²) affected 20-22%, and albuminuria persisted in over 50%.
- Pregnancy-related acute kidney injury (Pr-AKI) predicted reduced eGFR and albuminuria; elevated BMI predicted hypertension; HIV predicted reduced eGFR.
Conclusions:
- Cardio-renal sequelae post-preeclampsia are highly prevalent, necessitating integrated postpartum care.
- Pr-AKI is a significant predictor of chronic kidney disease (CKD) development.
- This study emphasizes the importance of monitoring kidney function and cardiovascular health after preeclampsia.
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