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Background It is unknown whether preeclampsia is a risk marker for subsequent end-stage renal disease (ESRD).
Methods We linked data from the Medical Birth Registry of Norway, which contains data on all births in Norway since 1967, with data from the Norwegian Renal Registry, which contains data on all patients receiving a diagnosis of end-stage renal disease (ESRD) since 1980, to assess the association between preeclampsia in one or more pregnancies and the subsequent development of ESRD. The study population consisted of women who had had a first singleton birth between 1967 and 1991; we included data from up to three pregnancies.
Results ESRD developed in 477 of 570,433 women a mean (±SD) of 17±9 years after the first pregnancy (overall rate, 3.7 per 100,000 women per year). Among women who had been pregnant one or more times, preeclampsia during the first pregnancy was associated with a relative risk of ESRD of 4.7 (95% confidence interval [CI], 3.6 to 6.1). Among women who had been pregnant two or more times, preeclampsia during the first pregnancy was associated with a relative risk of ESRD of 3.2 (95% CI, 2.2 to 4.9), preeclampsia during the second pregnancy with a relative risk of 6.7 (95% CI, 4.3 to 10.6), and preeclampsia during both pregnancies with a relative risk of 6.4 (95% CI, 3.0 to 13.5). Among women who had been pregnant three or more times, preeclampsia during one pregnancy was associated with a relative risk of ESRD of 6.3 (95% CI, 4.1 to 9.9), and preeclampsia during two or three pregnancies was associated with a relative risk of 15.5 (95% CI, 7.8 to 30.8). Having a low-birth-weight or preterm infant increased the relative risk of ESRD. The results were similar after adjustment for possible confounders and after exclusion of women who had kidney disease, rheumatic disease, essential hypertension, or diabetes mellitus before pregnancy.
Conclusions Although the absolute risk of ESRD in women who have had preeclampsia is low, preeclampsia is a marker for an increased risk of subsequent ESRD.
Source Information
From the Renal Research Group, Institute of Medicine (B.E.V., B.M.I.), the Section for Epidemiology and Medical Statistics (L.M.I., R.S.), and the Locus for Registry-Based Epidemiology (B.E.V., L.M.I., R.S., B.M.I.), University of Bergen; the Department of Medicine, Haukeland University Hospital (B.E.V., B.M.I.); and the Medical Birth Registry of Norway, Norwegian Institute of Public Health (L.M.I., R.S.) — all in Bergen, Norway; and the Norwegian Renal Registry, Institute of Immunology, Rikshospitalet, Oslo (T.L.).
Address reprint requests to Dr. Vikse at the Renal Research Group, Institute of Medicine, Haukeland University Hospital, Bergen 5021, Norway, or at bjorn.vikse{at}med.uib.no.
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