Hypertension during pregnancy ups risk of chronic kidney disease

A study has found that women with hypertensive disorders during pregnancy are at higher risk of chronic kidney disease and end-stage renal disease compared with women without the disorders.

Hypertensive disorders such as gestational hypertension and preeclampsia in pregnancy can have a major impact on the health of the mother and baby and are risk factors for death. An estimated 5 percent to 10 percent of pregnancies are affected by hypertensive disorders. Kidney function can be affected.

Dr. I-Kuan Wang, Division of Nephrology, China Medical University Hospital, Taichung, Taiwan, and his team looked at data on 26 651 women in Taiwan with hypertensive disorders in their first pregnancy to determine whether there was an increased risk of end-stage renal disease compared with a group of 213 397 women without the disorders. The women were 19 to 40 years old and did not have a history of hypertension, diabetes or kidney disease.

The incidence of chronic kidney disease was almost 11-fold higher in the group with hypertensive disorders in pregnancy compared with the women without the disorders. End-stage renal disease was 14-fold higher in the cohort with hypertensive disorders. The risk for women with preeclampsia was higher than for those with only gestational hypertension.

This study is consistent with a Norwegian study that found a similar link between these disorders and later kidney disease.

"Close surveillance for microalbuminuria, blood pressure and diabetes should be considered for women with a history of hypertensive disorders during pregnancy. Preventive strategies, such as pharmacologic or lifestyle interventions, should also be considered for women at high risk of end-stage renal disease," the researchers concluded.

The finding appeared in CMAJ (Canadian Medical Association Journal).