Bianchi Gaia, Vogt Bruno, Bargagli Matteo, Ferrier Claudia
Faculty of Medicine, University of Berne, Berne, Switzerland.
University Clinic of Nephrology and Hypertension, Inselspital Berne, Berne, Switzerland.
Int Urol Nephrol. 2025 Jun 7. doi: 10.1007/s11255-025-04591-2.
Pre-eclampsia (PE) is a pregnancy-related multisystem syndrome, characterized by the sudden onset of hypertension after 20 weeks' gestation. Although previous studies and meta-analyses found an association between pre-eclampsia and chronic kidney disease or end-stage kidney disease later in life, it remains unclear whether this relationship is causal. Furthermore, research conducted to date has not consistently excluded women with chronic hypertension and/or kidney disease prior to pregnancy, indicating a possible selection bias. Therefore, we undertook a systematic review of the updated literature on renal outcomes in women who were healthy prior to pregnancy and experienced pre-eclampsia.
We searched PubMed-MEDLINE and Embase for eligible studies. We included retrospective and prospective studies involving healthy women with pre-eclampsia and reporting kidney outcomes. Of the 2,796 titles originally screened, 9 studies met our inclusion criteria. A random effects meta-analytic model was used for statistical analysis.
A statistically significant increase in the risk of developing chronic kidney disease and end-stage kidney disease later in life following pre-eclampsia was found (meta-analytic risk ratios [95% confidence interval]: 1.83 [1.16-2.89] and 8.96 [4.94-16.23], respectively), with high statistical heterogeneity. However, the only prospective study did not find a significant association between pre-eclampsia and chronic kidney disease.
Although a significant association was identified, its clinical relevance and causality remain unclear. Postpartum medical investigation in women affected by pre-eclampsia is essential, but long-term follow-up may not be indicated in the absence of underlying conditions. Only prospective studies could clarify the relationship between pre-eclampsia and kidney disease in women who were healthy before pregnancy.
子痫前期（PE）是一种与妊娠相关的多系统综合征，其特征为妊娠20周后突然出现高血压。尽管先前的研究和荟萃分析发现子痫前期与慢性肾脏病或晚年的终末期肾病之间存在关联，但这种关系是否为因果关系仍不清楚。此外，迄今为止进行的研究并未始终排除妊娠前患有慢性高血压和/或肾病的女性，这表明可能存在选择偏倚。因此，我们对妊娠前健康且患子痫前期的女性肾脏结局的最新文献进行了系统评价。
我们在PubMed-MEDLINE和Embase中检索符合条件的研究。我们纳入了涉及患子痫前期的健康女性并报告肾脏结局的回顾性和前瞻性研究。在最初筛选的2796篇标题中，有9项研究符合我们的纳入标准。采用随机效应荟萃分析模型进行统计分析。
发现子痫前期后患慢性肾脏病和终末期肾病的风险有统计学意义的增加（荟萃分析风险比[95%置信区间]：分别为1.83[1.16-2.89]和8.96[4.94-16.23]），具有高度统计学异质性。然而，唯一的前瞻性研究未发现子痫前期与慢性肾脏病之间存在显著关联。
尽管发现了显著关联，但其临床相关性和因果关系仍不清楚。子痫前期患者产后进行医学检查至关重要，但在没有潜在疾病的情况下可能无需长期随访。只有前瞻性研究才能阐明妊娠前健康女性子痫前期与肾病之间的关系。
