title: Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors: Graduate Institute of Clinical Medical Science, the Department of Internal Medicine, China Medical University Hospital, and the Department of Public Health, China Medical University, Taichung, Taiwan.
authors: I-Kuan
authors: IK
authors: Wang
authors: Chih-Hsin
authors: CH
authors: Muo
authors: Yi-Chih
authors: YC
authors: Chang
authors: Chih-Chia
authors: CC
authors: Liang
authors: Chiz-Tzung
authors: CT
authors: Chang
authors: Shih-Yi
authors: SY
authors: Lin
authors: Tzung-Hai
authors: TH
authors: Yen
authors: Feng-Rong
authors: FR
authors: Chuang
authors: Pei-Chun
authors: PC
authors: Chen
authors: Chiu-Ching
authors: CC
authors: Huang
authors: Chi-Pang
authors: CP
authors: Wen
authors: Fung-Chang
authors: FC
authors: Sung
authors: Donald E
authors: DE
authors: Morisky
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004461:Eclampsia / Q000453:epidemiology; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012307:Risk Factors