Haudiquet Marie, D'Incau Marion, Letouzey Vincent, Moranne Olivier
Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France.
UMR Inserm, Epidemiology and Public Health (IDESP), Faculty of Medicine Montpellier, Montpellier, France.
Acta Obstet Gynecol Scand. 2025 Jul;104(7):1254-1273. doi: 10.1111/aogs.15127. Epub 2025 Apr 24.
Preeclampsia is a pregnancy syndrome defined by high blood pressure (≥140/90 mmHg) and at least one other associated complication, including proteinuria, maternal organ dysfunction, or uteroplacental dysfunction, after 20 weeks of gestation. The long-term effects of this disease on the kidneys are still not fully understood. This systematic review aimed to evaluate the risk of chronic kidney disease after preeclampsia and the determinants of these sequelae.
We included observational studies on kidney outcomes from cohorts of women with a history of preeclampsia from the PubMed, Web of Science, and Cochrane databases.
Two hundred and seventy-seven articles were evaluated. Thirty-one (published between 2000 and 2022) were included in this systematic review. Twenty-two authors focused on the risk of chronic kidney disease and/or persistent proteinuria. Five authors found a more significant risk of kidney disease after preeclampsia, with a risk ranging from two to three times higher. Regarding end-stage kidney disease, most studies found a risk of between 4 and 14 times higher of developing end-stage kidney disease after preeclampsia. For several authors, early preeclampsia, preterm delivery, and recurrent pregnancies complicated by preeclampsia seemed to be the three major factors for determining the risk of kidney sequelae or proteinuria.
Women with a history of preeclampsia have a greater risk of chronic kidney disease or end-stage kidney disease. Some determinants seem to increase the risk. Further research is required to identify these determinants of kidney sequelae.
子痫前期是一种妊娠综合征，定义为妊娠20周后出现高血压（≥140/90 mmHg）以及至少一种其他相关并发症，包括蛋白尿、母体器官功能障碍或子宫胎盘功能障碍。这种疾病对肾脏的长期影响仍未完全了解。本系统评价旨在评估子痫前期后慢性肾脏病的风险以及这些后遗症的决定因素。
我们纳入了来自PubMed、科学网和Cochrane数据库中具有子痫前期病史女性队列的肾脏结局观察性研究。
共评估了277篇文章。本系统评价纳入了31篇（发表于2000年至2022年之间）。22位作者关注慢性肾脏病和/或持续性蛋白尿的风险。5位作者发现子痫前期后患肾脏病的风险更高，风险高出两到三倍。关于终末期肾病，大多数研究发现子痫前期后患终末期肾病的风险高出4至14倍。对于几位作者来说，早发型子痫前期、早产以及复发性子痫前期妊娠似乎是决定肾脏后遗症或蛋白尿风险的三个主要因素。
有子痫前期病史的女性患慢性肾脏病或终末期肾病的风险更高。一些决定因素似乎会增加风险。需要进一步研究以确定这些肾脏后遗症的决定因素。
