Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cardiorenal Med. 2020;10(3):188-197. doi: 10.1159/000506469. Epub 2020 Apr 16.
Although preeclampsia (PE), as an endothelial disorder can lead to renal dysfunction during pregnancy, results of studies focusing on the potential long-term potential effects of PE on renal function are insufficient and those available are controversial. This study investigated the incidence rate and risk of chronic kidney disease (CKD) among women with prior history of PE compared with healthy controls in a long-term population-based study.
This was a prospective population-based cohort study. Subjects were 1,851 eligible women, aged 20-50 years, with at least 1 pregnancy (177 women with prior-PE and 1,674 non-PE controls) selected from among the Tehran-Lipid and Glucose-Study-participants. A pooled-logistic-regression-model and Cox's-proportional-hazards-models were utilized to estimate the risk of CKD in women of both PE and without PE groups, after further adjustment for confounders.
Median and interquartile ranges for follow-up durations of the PE and non-PE groups were 7.78 (5.19-10.40) and 7.32 (4.73-11.00) years, respectively. Total cumulative incidence rates of CKD at the median follow-up time of each group were 35/100,000 (95% CI 25/100,000-50/100,000) and 36/100,000 (95% CI 32/100,000-39/100,000) in PE and non-PE women, respectively (p value = 0.90). Based on pooled-logistic-regression-analysis, OR of CKD progression (adjusted for age, body mass index [BMI], systolic blood pressure [SBP], and diastolic blood pressure [DBP]) for the PE group did not differ, compared to their non-PE counterparts (OR 1.04; p value = 0.80; 95% CI 0.77-1.40). Compared to non-PE women, women with prior PE did not have higher hazard ratios (HRs) of developing CKD in the unadjusted model (unadjusted HR 1.1, 95% CI 0.83-1.69, p = 0.35), results which remained unchanged after adjustment for age, BMI, baseline SBP, and DBP.
PE was not found to be a risk factor for CKD. More studies using a prospective cohort design with long-term follow-ups are needed to investigate the relationship between preeclamsia and CKD.
子痫前期（PE）是一种内皮功能紊乱，可导致孕妇肾功能障碍，但目前针对 PE 对肾功能的潜在长期影响的研究结果尚不足，且存在争议。本研究通过一项长期基于人群的研究，调查了既往有 PE 病史的女性与健康对照组相比，慢性肾脏病（CKD）的发病率和风险。
这是一项前瞻性基于人群的队列研究。从德黑兰血脂和血糖研究参与者中选择了 1851 名年龄在 20-50 岁之间、至少有一次妊娠（177 名有 PE 病史，1674 名无 PE 对照）的合格女性。采用汇总逻辑回归模型和 Cox 比例风险模型，进一步调整混杂因素后，估计两组女性的 CKD 风险。
PE 组和无 PE 组的中位随访时间分别为 7.78（5.19-10.40）和 7.32（4.73-11.00）年。两组的总累积 CKD 发生率在中位随访时间分别为 35/100,000（95%CI 25/100,000-50/100,000）和 36/100,000（95%CI 32/100,000-39/100,000）。PE 和无 PE 女性的差异无统计学意义（p 值=0.90）。基于汇总逻辑回归分析，PE 组 CKD 进展的 OR（调整年龄、体重指数[BMI]、收缩压[SBP]和舒张压[DBP]）与非 PE 组相比无差异（OR 1.04；p 值=0.80；95%CI 0.77-1.40）。与无 PE 女性相比，未经调整模型中，PE 病史女性的 CKD 发生风险比（HR）无显著升高（未经调整 HR 1.1，95%CI 0.83-1.69，p=0.35），在调整年龄、BMI、基线 SBP 和 DBP 后，结果仍然不变。
PE 不是 CKD 的危险因素。需要更多采用前瞻性队列设计和长期随访的研究来探讨子痫前期与 CKD 之间的关系。
