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Pre-eclampsia and risk of later kidney disease: nationwide cohort study

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Kristensen, JH, Basit, S, Wohlfahrt, J, Damholt, MB & Boyd, HA 2019, 'Pre-eclampsia and risk of later kidney disease: nationwide cohort study' BMJ, bind 365, 1516, s. l1516. https://doi.org/10.1136/bmj.l1516

APA

Kristensen, J. H., Basit, S., Wohlfahrt, J., Damholt, M. B., & Boyd, H. A. (2019). Pre-eclampsia and risk of later kidney disease: nationwide cohort study. BMJ, 365, l1516. [1516]. https://doi.org/10.1136/bmj.l1516

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Author

Kristensen, Jonas H ; Basit, Saima ; Wohlfahrt, Jan ; Damholt, Mette Brimnes ; Boyd, Heather A. / Pre-eclampsia and risk of later kidney disease : nationwide cohort study. I: BMJ. 2019 ; Bind 365. s. l1516.

Bibtex

@article{5cf86ab5e3494eeb9914533baa84e90c,
title = "Pre-eclampsia and risk of later kidney disease: nationwide cohort study",
abstract = "OBJECTIVE: To investigate associations between pre-eclampsia and later risk of kidney disease.DESIGN: Nationwide register based cohort study.SETTING: Denmark.POPULATION: All women with at least one pregnancy lasting at least 20 weeks between 1978 and 2015.MAIN OUTCOME MEASURE: Hazard ratios comparing rates of kidney disease between women with and without a history of pre-eclampsia, stratified by gestational age at delivery and estimated using Cox regression.RESULTS: The cohort consisted of 1 072 330 women followed for 19 994 470 person years (average 18.6 years/woman). Compared with women with no previous pre-eclampsia, those with a history of pre-eclampsia were more likely to develop chronic renal conditions: hazard ratio 3.93 (95{\%} confidence interval 2.90 to 5.33, for early preterm pre-eclampsia (delivery <34 weeks); 2.81 (2.13 to 3.71) for late preterm pre-eclampsia (delivery 34-36 weeks); 2.27 (2.02 to 2.55) for term pre-eclampsia (delivery ≥37 weeks). In particular, strong associations were observed for chronic kidney disease, hypertensive kidney disease, and glomerular/proteinuric disease. Adjustment for cardiovascular disease and hypertension only partially attenuated the observed associations. Stratifying the analyses on time since pregnancy showed that associations between pre-eclampsia and chronic kidney disease and glomerular/proteinuric disease were much stronger within five years of the latest pregnancy (hazard ratio 6.11 (3.84 to 9.72) and 4.77 (3.88 to 5.86), respectively) than five years or longer after the latest pregnancy (2.06 (1.69 to 2.50) and 1.50 (1.19 to 1.88). By contrast, associations between pre-eclampsia and acute renal conditions were modest.CONCLUSION: s Pre-eclampsia, particularly early preterm pre-eclampsia, was strongly associated with several chronic renal disorders later in life. More research is needed to determine which women are most likely to develop kidney disease after pre-eclampsia, what mechanisms underlie the association, and what clinical follow-up and interventions (and in what timeframe post-pregnancy) would be most appropriate and effective.",
keywords = "Adult, Cardiovascular Diseases/complications, Denmark/epidemiology, Female, Gestational Age, Humans, Hypertension/complications, Hypertension, Renal/complications, Kidney Diseases/diagnosis, Monitoring, Physiologic/standards, Postpartum Period, Pre-Eclampsia/diagnosis, Pregnancy, Risk Factors, Young Adult",
author = "Kristensen, {Jonas H} and Saima Basit and Jan Wohlfahrt and Damholt, {Mette Brimnes} and Boyd, {Heather A}",
note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.",
year = "2019",
month = "4",
day = "29",
doi = "10.1136/bmj.l1516",
language = "English",
volume = "365",
pages = "l1516",
journal = "BMJ",
issn = "1756-1833",
publisher = "B M J Group",

}

RIS

TY - JOUR

T1 - Pre-eclampsia and risk of later kidney disease

T2 - nationwide cohort study

AU - Kristensen, Jonas H

AU - Basit, Saima

AU - Wohlfahrt, Jan

AU - Damholt, Mette Brimnes

AU - Boyd, Heather A

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2019/4/29

Y1 - 2019/4/29

N2 - OBJECTIVE: To investigate associations between pre-eclampsia and later risk of kidney disease.DESIGN: Nationwide register based cohort study.SETTING: Denmark.POPULATION: All women with at least one pregnancy lasting at least 20 weeks between 1978 and 2015.MAIN OUTCOME MEASURE: Hazard ratios comparing rates of kidney disease between women with and without a history of pre-eclampsia, stratified by gestational age at delivery and estimated using Cox regression.RESULTS: The cohort consisted of 1 072 330 women followed for 19 994 470 person years (average 18.6 years/woman). Compared with women with no previous pre-eclampsia, those with a history of pre-eclampsia were more likely to develop chronic renal conditions: hazard ratio 3.93 (95% confidence interval 2.90 to 5.33, for early preterm pre-eclampsia (delivery <34 weeks); 2.81 (2.13 to 3.71) for late preterm pre-eclampsia (delivery 34-36 weeks); 2.27 (2.02 to 2.55) for term pre-eclampsia (delivery ≥37 weeks). In particular, strong associations were observed for chronic kidney disease, hypertensive kidney disease, and glomerular/proteinuric disease. Adjustment for cardiovascular disease and hypertension only partially attenuated the observed associations. Stratifying the analyses on time since pregnancy showed that associations between pre-eclampsia and chronic kidney disease and glomerular/proteinuric disease were much stronger within five years of the latest pregnancy (hazard ratio 6.11 (3.84 to 9.72) and 4.77 (3.88 to 5.86), respectively) than five years or longer after the latest pregnancy (2.06 (1.69 to 2.50) and 1.50 (1.19 to 1.88). By contrast, associations between pre-eclampsia and acute renal conditions were modest.CONCLUSION: s Pre-eclampsia, particularly early preterm pre-eclampsia, was strongly associated with several chronic renal disorders later in life. More research is needed to determine which women are most likely to develop kidney disease after pre-eclampsia, what mechanisms underlie the association, and what clinical follow-up and interventions (and in what timeframe post-pregnancy) would be most appropriate and effective.

AB - OBJECTIVE: To investigate associations between pre-eclampsia and later risk of kidney disease.DESIGN: Nationwide register based cohort study.SETTING: Denmark.POPULATION: All women with at least one pregnancy lasting at least 20 weeks between 1978 and 2015.MAIN OUTCOME MEASURE: Hazard ratios comparing rates of kidney disease between women with and without a history of pre-eclampsia, stratified by gestational age at delivery and estimated using Cox regression.RESULTS: The cohort consisted of 1 072 330 women followed for 19 994 470 person years (average 18.6 years/woman). Compared with women with no previous pre-eclampsia, those with a history of pre-eclampsia were more likely to develop chronic renal conditions: hazard ratio 3.93 (95% confidence interval 2.90 to 5.33, for early preterm pre-eclampsia (delivery <34 weeks); 2.81 (2.13 to 3.71) for late preterm pre-eclampsia (delivery 34-36 weeks); 2.27 (2.02 to 2.55) for term pre-eclampsia (delivery ≥37 weeks). In particular, strong associations were observed for chronic kidney disease, hypertensive kidney disease, and glomerular/proteinuric disease. Adjustment for cardiovascular disease and hypertension only partially attenuated the observed associations. Stratifying the analyses on time since pregnancy showed that associations between pre-eclampsia and chronic kidney disease and glomerular/proteinuric disease were much stronger within five years of the latest pregnancy (hazard ratio 6.11 (3.84 to 9.72) and 4.77 (3.88 to 5.86), respectively) than five years or longer after the latest pregnancy (2.06 (1.69 to 2.50) and 1.50 (1.19 to 1.88). By contrast, associations between pre-eclampsia and acute renal conditions were modest.CONCLUSION: s Pre-eclampsia, particularly early preterm pre-eclampsia, was strongly associated with several chronic renal disorders later in life. More research is needed to determine which women are most likely to develop kidney disease after pre-eclampsia, what mechanisms underlie the association, and what clinical follow-up and interventions (and in what timeframe post-pregnancy) would be most appropriate and effective.

KW - Adult

KW - Cardiovascular Diseases/complications

KW - Denmark/epidemiology

KW - Female

KW - Gestational Age

KW - Humans

KW - Hypertension/complications

KW - Hypertension, Renal/complications

KW - Kidney Diseases/diagnosis

KW - Monitoring, Physiologic/standards

KW - Postpartum Period

KW - Pre-Eclampsia/diagnosis

KW - Pregnancy

KW - Risk Factors

KW - Young Adult

UR - http://www.scopus.com/inward/record.url?scp=85065163842&partnerID=8YFLogxK

U2 - 10.1136/bmj.l1516

DO - 10.1136/bmj.l1516

M3 - Journal article

VL - 365

SP - l1516

JO - BMJ

JF - BMJ

SN - 1756-1833

M1 - 1516

ER -

ID: 58587367