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Impacto de la Preeclampsia en la Función Renal a Largo Plazo en un Entorno de Bajos Recursos
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
Resumen
La preeclampsia provoca problemas renales e hipertensión a largo plazo, especialmente en mujeres con lesión renal aguda relacionada con el embarazo (Pr-AKI). La vigilancia posparto integrada es crucial para controlar estas secuelas cardiorrenales.
Área de la Ciencia:
- Obstetricia y Ginecología; Nefrología; Cardiología
Sus antecedentes:
- Los trastornos hipertensivos del embarazo (THE) afectan al 10% de los embarazos a nivel mundial, con mayores riesgos en países de ingresos bajos y medianos.; Se conocen complicaciones cardiovasculares y renales a largo plazo después de la preeclampsia en entornos de altos ingresos, pero los datos de los países de ingresos bajos y medianos son limitados.; Este estudio investiga la hipertensión persistente, la disfunción renal y la albuminuria después de la preeclampsia en una cohorte sudafricana.
Objetivo del estudio:
- Evaluar la incidencia y persistencia de hipertensión, tasa de filtración glomerular estimada (TFG) reducida y albuminuria después de la preeclampsia.; Identificar los factores de riesgo asociados con estas secuelas cardiorrenales a largo plazo.; Destacar la necesidad de vigilancia posparto en supervivientes de preeclampsia.
Principales métodos:
- Estudio de cohorte prospectivo en el Hospital Groote Schuur, Sudáfrica (2020-2024).; Se recopilaron datos clínicos, demográficos y bioquímicos en el parto y en los seguimientos de 1 y 2 años.; Se utilizó regresión logística para analizar los predictores de hipertensión, TFG estimada reducida y albuminuria.
Principales resultados:
- Se observó hipertensión persistente en el 44-47% de las mujeres hasta 2 años después del parto.; La TFG estimada reducida (< 90 ml/min/1.73 m²) afectó al 20-22%, y la albuminuria persistió en más del 50%.; La lesión renal aguda relacionada con el embarazo (Pr-AKI) predijo una TFG estimada reducida y albuminuria; el IMC elevado predijo hipertensión; el VIH predijo una TFG estimada reducida.
Conclusiones:
- Las secuelas cardiorrenales después de la preeclampsia son muy prevalentes, lo que requiere atención posparto integrada.; La Pr-AKI es un predictor significativo del desarrollo de enfermedad renal crónica (ERC).; Este estudio enfatiza la importancia de monitorear la función renal y la salud cardiovascular después de la preeclampsia.
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