Gestational hypertension and preeclampsia in living kidney donors.
BACKGROUND
Young women wishing to become living kidney donors frequently ask whether nephrectomy will affect their future pregnancies.


METHODS
We conducted a retrospective cohort study of living kidney donors involving 85 women (131 pregnancies after cohort entry) who were matched in a 1:6 ratio with 510 healthy nondonors from the general population (788 pregnancies after cohort entry). Kidney donations occurred between 1992 and 2009 in Ontario, Canada, with follow-up through linked health care databases until March 2013. Donors and nondonors were matched with respect to age, year of cohort entry, residency (urban or rural), income, number of pregnancies before cohort entry, and the time to the first pregnancy after cohort entry. The primary outcome was a hospital diagnosis of gestational hypertension or preeclampsia. Secondary outcomes were each component of the primary outcome examined separately and other maternal and fetal outcomes.


RESULTS
Gestational hypertension or preeclampsia was more common among living kidney donors than among nondonors (occurring in 15 of 131 pregnancies [11%] vs. 38 of 788 pregnancies [5%]; odds ratio for donors, 2.4; 95% confidence interval, 1.2 to 5.0; P=0.01). Each component of the primary outcome was also more common among donors (odds ratio, 2.5 for gestational hypertension and 2.4 for preeclampsia). There were no significant differences between donors and nondonors with respect to rates of preterm birth (8% and 7%, respectively) or low birth weight (6% and 4%, respectively). There were no reports of maternal death, stillbirth, or neonatal death among the donors. Most women had uncomplicated pregnancies after donation.


CONCLUSIONS
Gestational hypertension or preeclampsia was more likely to be diagnosed in kidney donors than in matched nondonors with similar indicators of baseline health. (Funded by the Canadian Institutes of Health Research and others.).
The authors' affiliations are provided in the Appendix.
Amit X
AX
Garg
Immaculate F
IF
Nevis
Eric
E
McArthur
Jessica M
JM
Sontrop
John J
JJ
Koval
Ngan N
NN
Lam
Ainslie M
AM
Hildebrand
Peter P
PP
Reese
Leroy
L
Storsley
John S
JS
Gill
Dorry L
DL
Segev
Steven
S
Habbous
Ann
A
Bugeja
Greg A
GA
Knoll
Christine
C
Dipchand
Mauricio
M
Monroy-Cuadros
Krista L
KL
Lentine
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016030:Kidney Transplantation; D019520:Living Donors; D009392:Nephrectomy; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies