title: Preeclampsia and ESRD: The Role of Shared Risk Factors.
abstract: BACKGROUND
  Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors.
  
  
  METHODS
  Population-based nested case-control study.
  
  
  METHODS
  The US Renal Data System was used to identify women with ESRD from a cohort of 34,581 women who gave birth in 1976 to 2010 in Olmsted County, MN. 44 cases of ESRD were identified and each one was matched to 2 controls based on year of birth (±1 year), age at first pregnancy (±2 years), and parity (±1 or ≥4).
  
  
  METHODS
  Preeclamptic pregnancy, confirmed by medical record review.
  
  
  RESULTS
  ESRD.
  
  
  METHODS
  Prepregnancy serum creatinine and urine protein measurements were recorded. Comorbid conditions existing prior to pregnancy were abstracted from medical records and included kidney disease, obesity, diabetes, and hypertension.
  
  
  RESULTS
  There was evidence of kidney disease prior to the first pregnancy in 9 of 44 (21%) cases and 1 of 88 (<1%) controls. Per chart review, 8 of 44 (18%) cases versus 4 of 88 (5%) controls had preeclamptic pregnancies (unadjusted OR, 4.0; 95% CI, 1.21-13.28). Results were similar after independent adjustment for race, education, diabetes, and hypertension prior to pregnancy. However, the association was attenuated and no longer significant after adjustment for obesity (OR, 3.25; 95% CI, 0.93-11.37).
  
  
  CONCLUSIONS
  The limited number of ESRD cases and missing data for prepregnancy kidney function.
  
  
  CONCLUSIONS
  Our findings confirm that there is a sizable association between preeclampsia and ESRD; however, obesity is a previously unexplored confounder. Pre-existing kidney disease was common, but not consistently coded or diagnosed.
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Kattah
authors.affiliation: Department of Cardiovascular Services, The Queen Elizabeth Hospital, Barbados.
authors.forename: Dawn C
authors.initials: DC
authors.lastname: Scantlebury
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
authors.forename: Sanket
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Neurology, Mayo Clinic, Rochester, MN.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Mielke
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Neurology, Mayo Clinic, Rochester, MN.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Rocca
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Vaughan
authors.affiliation: Department of Physiology and Biomedical Engineering, Department of Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Miller
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Weissgerber
authors.affiliation: Division of Maternal Fetal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Wendy
authors.initials: W
authors.lastname: White
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN. Electronic address: garovic.vesna@mayo.edu.
authors.forename: Vesna D
authors.initials: VD
authors.lastname: Garovic
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000209:etiology*; D007677:Kidney Function Tests; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000209:etiology*; D011247:Pregnancy; D012008:Recurrence; D012307:Risk Factors; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D003404:Creatinine
keywords: Preeclampsia; end-stage renal disease (ESRD); hypertension; hypertensive pregnancy disorders; obesity; pregnancy; risk factor; toxemia