Hypertension during pregnancy linked with end-stage renal disease

Researchers in Taiwan have found that women with hypertensive disorders during pregnancy are at a high risk for end-stage renal disease. The risk was much greater for women who had preeclampsia or eclampsia than for those who had only gestational hypertension.

A report on the study appears on the website of the Canadian Medical Association Journal.

The incidence and prevalence of end-stage renal disease in Taiwan are among the highest in the world, the researchers note. Moreover, they claim that studies regarding hypertensive disorders during pregnancy and end-stage renal disease are limited. “Only 1 study, performed using birth and renal registries from Norway, has reported that women with preeclampsia during their first pregnancy had a 3.2-fold higher risk of end-stage renal disease,” they note.

To conduct their study, the researchers used insurance claims data from 1998 to 2009 to identify 26,651 women in Taiwan who experienced hypertensive disorders during pregnancy. The women were aged 19 to 40 years and had no history of hypertension, diabetes, kidney disease, or lupus. The researchers compared these women to a cohort of 213,397 women without hypertensive disorders during pregnancy. They compared the incidence of end-stage renal disease in the 2 cohorts and calculated hazard ratios (HRs) and 95% confidence intervals (CIs) after controlling for demographic and clinical factors.

The researchers found that the incidence of end-stage renal disease was 14.1-fold higher among women who had had hypertensive disorders during pregnancy than among those who had not (crude HR 14.1, 95% CI 9.76–10.30)

Postpartum hypertension and diabetes increased the risk further. The researchers noted that the risk of end-stage renal disease is likely higher in the Taiwanese population than in Western populations.

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