The effect of preeclampsia on long-term kidney function among pregnant women with chronic kidney disease.

IF 4.8 2区医学 Q1 TRANSPLANTATION Nephrology Dialysis Transplantation Pub Date : 2025-02-04 DOI:10.1093/ndt/gfae172

Zheng Li, Shi Chen, Ying Tan, Jicheng Lv, Minghui Zhao, Qian Chen, Yingdong He

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Abstract

Background: The association between superimposed preeclampsia and an elevated risk of long-term kidney function decline or end-stage kidney disease (ESKD) in patients with chronic kidney disease (CKD) has not been determined. This study aimed to analyze the association between preeclampsia and kidney function deterioration in CKD patients.

Methods: This was a retrospective cohort study that included the clinical information of 103 pregnant CKD patients with preeclampsia and 103 matched CKD patients without preeclampsia who were followed-up for a minimum of 1 year after their first pregnancy from 1 January 2009 to 31 May 2022. Robust Cox regression analysis was also conducted to evaluate the effects of preeclampsia on long-term kidney function decline or ESKD in CKD patients. Kaplan-Meier curves were used to compare renal survival within different subgroups via the log-rank test.

Results: During the follow-up period, 44 (42.72%) CKD patients with preeclampsia and 20 (19.42%) without preeclampsia had an estimated glomerular filtration rate (eGFR) decrease >30% or developed ESKD. Compared with CKD patients without preeclampsia, the eGFR decreased more significantly in patients with preeclampsia [98.43 (79.48, 116.47) to 81.32 (41.20, 102.97) mL/min/1.73 m2 vs 99.43 (79.00, 118.50) to 89.44 (63.69, 105.30) mL/min/1.73 m2; P = .034]. The rate of eGFR decrease was more pronounced in patients with preeclampsia (17.38% vs 10.05%, P < .05). Multivariate analysis revealed that early-onset preeclampsia (preeclampsia that developed before 34 weeks of gestation) [hazard ratio (HR) = 2.61, 95% confidence interval (CI) 1.32-5.16, P = 0.006] and late-onset preeclampsia (HR = 2.54, 95% CI 1.34-4.83, P = .004) were both risk factors for an eGFR decrease >30% or ESKD.

Conclusion: Preeclampsia was associated with a greater risk of long-term kidney function decline or ESKD among CKD patients, especially in patients with early-onset preeclampsia.

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先兆子痫对患有慢性肾病的孕妇长期肾功能的影响。

背景和假设：慢性肾脏病（CKD）患者叠加子痫前期与长期肾功能衰退或终末期肾脏病（ESKD）风险升高之间的关系尚未确定。本研究旨在分析子痫前期与 CKD 患者肾功能恶化之间的关系：这是一项回顾性队列研究，包括103名患有子痫前期的CKD孕妇和103名匹配的无子痫前期的CKD患者的临床资料，这些患者自2009年1月1日至2022年5月31日首次妊娠后接受了至少1年的随访。此外，还进行了稳健的 Cox 回归分析，以评估先兆子痫对 CKD 患者长期肾功能下降或 ESKD 的影响。采用K-M曲线，通过对数秩检验比较不同亚组的肾脏存活率：在随访期间，44 名（42.72%）有子痫前期的 CKD 患者和 20 名（19.42%）无子痫前期的 CKD 患者的估计肾小球滤过率（eGFR）下降>30% 或出现 ESKD。与没有先兆子痫的 CKD 患者相比，先兆子痫患者的 eGFR 下降更明显 [98.43 (79.48, 116.47) to 81.32 (41.20, 102.97) mL/min/1.73 m2 vs. 99.43 (79.00, 118.50) to 89.44 (63.69, 105.30) mL/min/1.73 m2; P=0.034]。子痫前期患者的 eGFR 下降率更明显（17.38% 对 10.05%，P30% 或 ESKD）：结论：先兆子痫与 CKD 患者长期肾功能下降或 ESKD 的更大风险相关，尤其是在早发先兆子痫患者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephrology Dialysis Transplantation 医学-泌尿学与肾脏学

CiteScore

10.10

自引率

4.90%

发文量

1431

审稿时长

1.7 months

期刊介绍： Nephrology Dialysis Transplantation (ndt) is the leading nephrology journal in Europe and renowned worldwide, devoted to original clinical and laboratory research in nephrology, dialysis and transplantation. ndt is an official journal of the [ERA-EDTA](http://www.era-edta.org/) (European Renal Association-European Dialysis and Transplant Association). Published monthly, the journal provides an essential resource for researchers and clinicians throughout the world. All research articles in this journal have undergone peer review. Print ISSN: 0931-0509.