Pregnancy, Childbirth Complications Associated with Kidney Failure Later in Life
If you had preeclampsia during a pregnancy your risk for kidney failure later in life may be elevated. Results of a Norwegian study recently published in The New England Journal of Medicine indicate that a history of preeclampsia is associated with nearly a five times greater likelihood of end-stage renal disease later in life. Specifically, the study found greater risk of kidney disease severe enough to require dialysis or a kidney transplant.
Preeclampsia, which occurs during about 5% of pregnancies, is characterized by high blood pressure, swelling of the hands, face, feet or entire body, and the presence of protein in the urine during the second half of the pregnancy. Doctors at Haukeland University Hospital in Bergen, Norway, identified a few years ago that women who had preeclampsia during their first pregnancy were more likely to later need a kidney biopsy than women whose pregnancies were free of this complication.
New research by the same team goes further, confirming that the association between preeclampsia and later kidney failure is “strong,” according to Bjørn Egil Vikse, MD, PhD, a renal researcher and lead author of the study. “In Norway we are fortunate to have access to large databases of health information on virtually everyone born in the country since 1967,” he told me. Linking the Medical Births Registry of Norway with the Norwegian Renal Registry showed that women who gave birth to their first child in that country between 1967 and 1991 and who had also had preeclampsia during that pregnancy were more likely to have developed end stage renal disease later in life, on average 17 years afterward, he told me.
OTHER RISK FACTORS
An elevated risk of kidney failure was found in women who experienced preeclampsia with more than one pregnancy, as well as among women who had delivered prematurely or given birth to a low-birth-weight child, even if there was no preeclampsia. The registry does not contain information on such factors as whether the mothers at greater risk were also obese, smokers or had a history of high blood pressure, Dr. Vikse said, so those factors were not part of the study.
Dr. Vikse and his colleagues emphasize that the overall risk of end stage renal disease for a woman who had preeclampsia is very small, around 0.5%. But, because of the seriousness of kidney disease, he recommends that all women who have had preeclampsia, especially those who have given birth to a premature child (before the 37th week) or a baby with a low birth weight (less than 5.5 pounds) discuss these aspects of their health history with their physician and have regular cardiovascular examinations, since heart disease is also linked to preeclampsia and kidney disease. Though there is not yet information on how to prevent the problem, catching kidney disease in the early stages is far better than later on when much more damage will have occurred.