PT  - JOURNAL ARTICLE
AU  - Wang, I-Kuan
AU  - Muo, Chih-Hsin
AU  - Chang, Yi-Chih
AU  - Liang, Chih-Chia
AU  - Chang, Chiz-Tzung
AU  - Lin, Shih-Yi
AU  - Yen, Tzung-Hai
AU  - Chuang, Feng-Rong
AU  - Chen, Pei-Chun
AU  - Huang, Chiu-Ching
AU  - Wen, Chi-Pang
AU  - Sung, Fung-Chang
AU  - Morisky, Donald E.
TI  - Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study
AID  - 10.1503/cmaj.120230
DP  - 2013 Feb 19
TA  - Canadian Medical Association Journal
PG  - 207--213
VI  - 185
IP  - 3
4099  - http://www.cmaj.ca/content/185/3/207.short
4100  - http://www.cmaj.ca/content/185/3/207.full
SO  - CMAJ2013 Feb 19; 185
AB  - Background: Studies into the association between hypertensive disorders during pregnancy and end-stage renal disease are limited. We investigated the risk of end-stage renal disease after delivery among women with hypertensive disorders during pregnancy.Methods: We used insurance claims data from 1998 to 2009 to identify 26 651 women aged 19–40 years old who experienced hypertensive disorders during pregnancy; these women had no history of hypertension, diabetes, kidney disease or lupus. We also randomly selected 213 397 women without hypertensive disorders during pregnancy as a comparison cohort; the frequency was matched by age and index year of pregnancy. We compared the incidence of end-stage renal disease in the 2 cohorts. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) after controlling for demographic and clinical factors.Results: Women with hypertensive disorders during pregnancy had a greater risk of chronic kidney disease and end-stage renal disease, with adjusted HRs of 9.38 (95% CI 7.09–12.4) and 12.4 (95% CI 8.54–18.0), respectively, after controlling for urban status, coronary artery disease, congestive heart failure, hyperlipidemia and abruption. The HR for end-stage renal disease was 2.72 (95% CI 1.76–4.22) after we also controlled for hypertension and diabetes. Women with preeclampsia or eclampsia had a higher risk of end-stage renal disease (adjusted HR 14.0, 95% CI 9.43–20.7) than women who had gestational hypertension only (adjusted HR 9.03, 95% CI 5.20–15.7).Interpretation: Women with hypertensive disorders during pregnancy were at a high risk of end-stage renal disease. The risk was much greater for women who had preeclampsia or eclampsia than those who had gestational hypertension only.See related commentary by Spaan and Brown on page 199 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.130007