TY - JOUR
T1 - Preeclampsia and ESRD
T2 - The Role of Shared Risk Factors
AU - Kattah, Andrea G.
AU - Scantlebury, Dawn C.
AU - Agarwal, Sanket
AU - Mielke, Michelle M.
AU - Rocca, Walter A.
AU - Weaver, Amy L.
AU - Vaughan, Lisa E.
AU - Miller, Virginia M.
AU - Weissgerber, Tracey L.
AU - White, Wendy
AU - Garovic, Vesna D.
PY - 2016/4/5
Y1 - 2016/4/5
N2 - Background: Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors. Study Design: Population-based nested case-control study. Setting & Participants: The US Renal Data System was used to identify women with ESRD from a cohort of 34,581 women who gave birth in 1976 to 2010 in Olmsted County, MN. 44 cases of ESRD were identified and each one was matched to 2 controls based on year of birth (±1 year), age at first pregnancy (±2 years), and parity (±1 or ≥4). Predictor: Preeclamptic pregnancy, confirmed by medical record review. Outcome: ESRD. Measurements: Prepregnancy serum creatinine and urine protein measurements were recorded. Comorbid conditions existing prior to pregnancy were abstracted from medical records and included kidney disease, obesity, diabetes, and hypertension. Results: There was evidence of kidney disease prior to the first pregnancy in 9 of 44 (21%) cases and 1 of 88 (<1%) controls. Per chart review, 8 of 44 (18%) cases versus 4 of 88 (5%) controls had preeclamptic pregnancies (unadjusted OR, 4.0; 95% CI, 1.21-13.28). Results were similar after independent adjustment for race, education, diabetes, and hypertension prior to pregnancy. However, the association was attenuated and no longer significant after adjustment for obesity (OR, 3.25; 95% CI, 0.93-11.37). Limitations: The limited number of ESRD cases and missing data for prepregnancy kidney function. Conclusions: Our findings confirm that there is a sizable association between preeclampsia and ESRD; however, obesity is a previously unexplored confounder. Pre-existing kidney disease was common, but not consistently coded or diagnosed.
AB - Background: Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors. Study Design: Population-based nested case-control study. Setting & Participants: The US Renal Data System was used to identify women with ESRD from a cohort of 34,581 women who gave birth in 1976 to 2010 in Olmsted County, MN. 44 cases of ESRD were identified and each one was matched to 2 controls based on year of birth (±1 year), age at first pregnancy (±2 years), and parity (±1 or ≥4). Predictor: Preeclamptic pregnancy, confirmed by medical record review. Outcome: ESRD. Measurements: Prepregnancy serum creatinine and urine protein measurements were recorded. Comorbid conditions existing prior to pregnancy were abstracted from medical records and included kidney disease, obesity, diabetes, and hypertension. Results: There was evidence of kidney disease prior to the first pregnancy in 9 of 44 (21%) cases and 1 of 88 (<1%) controls. Per chart review, 8 of 44 (18%) cases versus 4 of 88 (5%) controls had preeclamptic pregnancies (unadjusted OR, 4.0; 95% CI, 1.21-13.28). Results were similar after independent adjustment for race, education, diabetes, and hypertension prior to pregnancy. However, the association was attenuated and no longer significant after adjustment for obesity (OR, 3.25; 95% CI, 0.93-11.37). Limitations: The limited number of ESRD cases and missing data for prepregnancy kidney function. Conclusions: Our findings confirm that there is a sizable association between preeclampsia and ESRD; however, obesity is a previously unexplored confounder. Pre-existing kidney disease was common, but not consistently coded or diagnosed.
KW - End-stage renal disease (ESRD)
KW - Hypertension
KW - Hypertensive pregnancy disorders
KW - Obesity
KW - Preeclampsia
KW - Pregnancy
KW - Risk factor
KW - Toxemia
UR - http://www.scopus.com/inward/record.url?scp=84999751242&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84999751242&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2016.07.034
DO - 10.1053/j.ajkd.2016.07.034
M3 - Article
C2 - 27707553
AN - SCOPUS:84999751242
SN - 0272-6386
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
ER -