Hypertensive disorders of pregnancies not a risk factor for kidney function decline
Hypertensive disorders of pregnancies (HDPs) do not appear to contribute to an increase in the incidence of chronic kidney disease (CKD), according to a study.
Researchers performed a subanalysis of the Prevention of Renal and Vascular End-stage Disease (PREVEND) study, a Dutch population-based cohort with follow-up of five visits spaced about 3 years apart. The analysis included 977 women with self-reported HDPs and 1,805 women without the maternal hypertensive disorder. The mean age at baseline was 50 years in the entire cohort.
Outcomes investigated included the incidence of CKD and the course of kidney function (estimated glomerular filtration rate [eGFR] and 24-hour albuminuria) over five visits. Analysis were performed using Cox regression and generalized estimating equation analysis adjusted for age, mean arterial pressure and renin-angiotensin system (RAS) blockade.
During a median follow-up of 11 years, none of the women developed end-stage renal disease. The incidence of CKD did not significantly differ between the HDP and non-HDP groups (hazard ratio [HR], 1.04; 95 percent CI, 0.79–1.37; p=0.8). Of note was the increased use of RAS blockade following HDP at all visits.
There was a marked decrease in estimated glomerular filtration rate (eGFR) observed in both groups, with the decline being greater in the HDP group (98 to 88 vs 99 to 91 mL/min/1.73 m2; pgroup<0.01; pgroup*visit<0.05). The group effect remained significant despite controlling for mean arterial pressure, but disappeared following adjustment for RAS blockade.
The 24-hour albuminuria was similar between the HDP and non-HDP groups.
The findings showed that HDPs did not increase the incidence of CKD, researchers said, adding that they were unable to identify a significant risk for kidney function decline after patient-reported HDP.