Gestational hypertension and preeclampsia in living kidney donors

DONOR Network

Research output: Contribution to journalArticle

Abstract

Background Young women wishing to become living kidney donors frequently ask whether nephrectomy will affect their future pregnancies. Methods We conducted a retrospective cohort study of living kidney donors involving 85 women (131 pregnancies after cohort entry) who were matched in a 1:6 ratio with 510 healthy nondonors from the general population (788 pregnancies after cohort entry). Kidney donations occurred between 1992 and 2009 in Ontario, Canada, with followup through linked health care databases until March 2013. Donors and nondonors were matched with respect to age, year of cohort entry, residency (urban or rural), income, number of pregnancies before cohort entry, and the time to the first pregnancy after cohort entry. The primary outcome was a hospital diagnosis of gestational hypertension or preeclampsia. Secondary outcomes were each component of the primary outcome examined separately and other maternal and fetal outcomes. Results Gestational hypertension or preeclampsia was more common among living kidney donors than among nondonors (occurring in 15 of 131 pregnancies [11%] vs. 38 of 788 pregnancies [5%]; odds ratio for donors, 2.4; 95% confidence interval, 1.2 to 5.0; P = 0.01). Each component of the primary outcome was also more common among donors (odds ratio, 2.5 for gestational hypertension and 2.4 for preeclampsia). There were no significant differences between donors and nondonors with respect to rates of preterm birth (8% and 7%, respectively) or low birth weight (6% and 4%, respectively). There were no reports of maternal death, stillbirth, or neonatal death among the donors. Most women had uncomplicated pregnancies after donation. Conclusions Gestational hypertension or preeclampsia was more likely to be diagnosed in kidney donors than in matched nondonors with similar indicators of baseline health. (Funded by the Canadian Institutes of Health Research and others.)

Original languageEnglish (US)
Pages (from-to)124-133
Number of pages10
JournalNew England Journal of Medicine
Volume372
Issue number2
DOIs
StatePublished - Jan 8 2015

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Pregnancy Induced Hypertension
Living Donors
Pre-Eclampsia
Kidney
Pregnancy
Tissue Donors
Time-to-Pregnancy
Odds Ratio
Maternal Death
Stillbirth
Premature Birth
Health
Low Birth Weight Infant
Ontario
Internship and Residency
Nephrectomy
Canada
Cohort Studies
Retrospective Studies
Mothers

ASJC Scopus subject areas

  • Medicine(all)

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Gestational hypertension and preeclampsia in living kidney donors. / DONOR Network.

In: New England Journal of Medicine, Vol. 372, No. 2, 08.01.2015, p. 124-133.

Research output: Contribution to journalArticle

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title = "Gestational hypertension and preeclampsia in living kidney donors",
abstract = "Background Young women wishing to become living kidney donors frequently ask whether nephrectomy will affect their future pregnancies. Methods We conducted a retrospective cohort study of living kidney donors involving 85 women (131 pregnancies after cohort entry) who were matched in a 1:6 ratio with 510 healthy nondonors from the general population (788 pregnancies after cohort entry). Kidney donations occurred between 1992 and 2009 in Ontario, Canada, with followup through linked health care databases until March 2013. Donors and nondonors were matched with respect to age, year of cohort entry, residency (urban or rural), income, number of pregnancies before cohort entry, and the time to the first pregnancy after cohort entry. The primary outcome was a hospital diagnosis of gestational hypertension or preeclampsia. Secondary outcomes were each component of the primary outcome examined separately and other maternal and fetal outcomes. Results Gestational hypertension or preeclampsia was more common among living kidney donors than among nondonors (occurring in 15 of 131 pregnancies [11{\%}] vs. 38 of 788 pregnancies [5{\%}]; odds ratio for donors, 2.4; 95{\%} confidence interval, 1.2 to 5.0; P = 0.01). Each component of the primary outcome was also more common among donors (odds ratio, 2.5 for gestational hypertension and 2.4 for preeclampsia). There were no significant differences between donors and nondonors with respect to rates of preterm birth (8{\%} and 7{\%}, respectively) or low birth weight (6{\%} and 4{\%}, respectively). There were no reports of maternal death, stillbirth, or neonatal death among the donors. Most women had uncomplicated pregnancies after donation. Conclusions Gestational hypertension or preeclampsia was more likely to be diagnosed in kidney donors than in matched nondonors with similar indicators of baseline health. (Funded by the Canadian Institutes of Health Research and others.)",
author = "{DONOR Network} and Garg, {Amit X.} and Nevis, {Immaculate F.} and Eric McArthur and Sontrop, {Jessica M.} and Koval, {John J.} and Lam, {Ngan N.} and Hildebrand, {Ainslie M.} and Reese, {Peter P.} and Leroy Storsley and Gill, {John S.} and Dorry Segev and Steven Habbous and Ann Bugeja and Knoll, {Greg A.} and Christine Dipchand and Mauricio Monroy-Cuadros and Lentine, {Krista L.}",
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T1 - Gestational hypertension and preeclampsia in living kidney donors

AU - DONOR Network

AU - Garg, Amit X.

AU - Nevis, Immaculate F.

AU - McArthur, Eric

AU - Sontrop, Jessica M.

AU - Koval, John J.

AU - Lam, Ngan N.

AU - Hildebrand, Ainslie M.

AU - Reese, Peter P.

AU - Storsley, Leroy

AU - Gill, John S.

AU - Segev, Dorry

AU - Habbous, Steven

AU - Bugeja, Ann

AU - Knoll, Greg A.

AU - Dipchand, Christine

AU - Monroy-Cuadros, Mauricio

AU - Lentine, Krista L.

PY - 2015/1/8

Y1 - 2015/1/8

N2 - Background Young women wishing to become living kidney donors frequently ask whether nephrectomy will affect their future pregnancies. Methods We conducted a retrospective cohort study of living kidney donors involving 85 women (131 pregnancies after cohort entry) who were matched in a 1:6 ratio with 510 healthy nondonors from the general population (788 pregnancies after cohort entry). Kidney donations occurred between 1992 and 2009 in Ontario, Canada, with followup through linked health care databases until March 2013. Donors and nondonors were matched with respect to age, year of cohort entry, residency (urban or rural), income, number of pregnancies before cohort entry, and the time to the first pregnancy after cohort entry. The primary outcome was a hospital diagnosis of gestational hypertension or preeclampsia. Secondary outcomes were each component of the primary outcome examined separately and other maternal and fetal outcomes. Results Gestational hypertension or preeclampsia was more common among living kidney donors than among nondonors (occurring in 15 of 131 pregnancies [11%] vs. 38 of 788 pregnancies [5%]; odds ratio for donors, 2.4; 95% confidence interval, 1.2 to 5.0; P = 0.01). Each component of the primary outcome was also more common among donors (odds ratio, 2.5 for gestational hypertension and 2.4 for preeclampsia). There were no significant differences between donors and nondonors with respect to rates of preterm birth (8% and 7%, respectively) or low birth weight (6% and 4%, respectively). There were no reports of maternal death, stillbirth, or neonatal death among the donors. Most women had uncomplicated pregnancies after donation. Conclusions Gestational hypertension or preeclampsia was more likely to be diagnosed in kidney donors than in matched nondonors with similar indicators of baseline health. (Funded by the Canadian Institutes of Health Research and others.)

AB - Background Young women wishing to become living kidney donors frequently ask whether nephrectomy will affect their future pregnancies. Methods We conducted a retrospective cohort study of living kidney donors involving 85 women (131 pregnancies after cohort entry) who were matched in a 1:6 ratio with 510 healthy nondonors from the general population (788 pregnancies after cohort entry). Kidney donations occurred between 1992 and 2009 in Ontario, Canada, with followup through linked health care databases until March 2013. Donors and nondonors were matched with respect to age, year of cohort entry, residency (urban or rural), income, number of pregnancies before cohort entry, and the time to the first pregnancy after cohort entry. The primary outcome was a hospital diagnosis of gestational hypertension or preeclampsia. Secondary outcomes were each component of the primary outcome examined separately and other maternal and fetal outcomes. Results Gestational hypertension or preeclampsia was more common among living kidney donors than among nondonors (occurring in 15 of 131 pregnancies [11%] vs. 38 of 788 pregnancies [5%]; odds ratio for donors, 2.4; 95% confidence interval, 1.2 to 5.0; P = 0.01). Each component of the primary outcome was also more common among donors (odds ratio, 2.5 for gestational hypertension and 2.4 for preeclampsia). There were no significant differences between donors and nondonors with respect to rates of preterm birth (8% and 7%, respectively) or low birth weight (6% and 4%, respectively). There were no reports of maternal death, stillbirth, or neonatal death among the donors. Most women had uncomplicated pregnancies after donation. Conclusions Gestational hypertension or preeclampsia was more likely to be diagnosed in kidney donors than in matched nondonors with similar indicators of baseline health. (Funded by the Canadian Institutes of Health Research and others.)

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