title: Long term effects of gestational hypertension and pre-eclampsia on kidney function: Record linkage study.
abstract: OBJECTIVE
  To assess the long term effects of hypertensive disorders of pregnancy on renal function.
  
  
  METHODS
  Cohort study where exposure was gestational hypertension or preeclampsia in the first pregnancy. Normotensive women formed the comparison group.
  
  
  METHODS
  Aberdeen, Scotland.
  
  
  METHODS
  All women with date of birth on or before 30th June 1969 and at least their first singleton delivery recorded in the Aberdeen Maternity and Neonatal Databank.
  
  
  METHODS
  Participants were linked to the Renal Biochemistry Register, Scottish Morbidity Records, Scottish Renal Registry and National Register for deaths.
  
  
  METHODS
  Occurrence of chronic kidney disease (CKD) as identified from renal function tests in later life, hospital admissions or death from kidney disease or recorded as receiving renal replacement therapy.
  
  
  RESULTS
  CKD was diagnosed in 7.5% and 5.2% of women who previously had GH and PE respectively compared to 3.9% in normotensive women. The unadjusted odds ratio (95% confidence interval) of having CKD in PE was 2.04 (1.53, 2.71) and that for GH was 1.37 (1.15, 1.65), while the adjusted odds ratio (95% confidence interval) of CKD was 1.93 (1.44, 2.57) and 1.36 (1.13, 1.63) in women with PE and GH respectively. Kaplan-Meier curves of survival time to development of chronic kidney disease revealed that women with preeclampsia were susceptible to kidney function impairment earliest, followed by those with gestational hypertension.
  
  
  CONCLUSIONS
  There was an increased subsequent risk of CKD associated with hypertensive disorders of pregnancy. Women with GH and PE were also found to have CKD earlier than normotensive women.
authors.affiliation: Division of Applied Health Sciences, University of Aberdeen, United Kingdom. Electronic address: d.ayansina@abdn.ac.uk.
authors.forename: D
authors.initials: D
authors.lastname: Ayansina
authors.affiliation: Chronic Diseases Group, Division of Applied Health Sciences, University of Aberdeen, United Kingdom. Electronic address: corri.black@abdn.ac.uk.
authors.forename: C
authors.initials: C
authors.lastname: Black
authors.affiliation: Chronic Diseases Group, Division of Applied Health Sciences, University of Aberdeen, United Kingdom.
authors.forename: S J
authors.initials: SJ
authors.lastname: Hall
authors.affiliation: Chronic Diseases Group, Division of Applied Health Sciences, University of Aberdeen, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Marks
authors.affiliation: NHS Grampian, United Kingdom. Electronic address: colin.millar@nhs.net.
authors.forename: C
authors.initials: C
authors.lastname: Millar
authors.affiliation: Division of Applied Health Sciences, University of Aberdeen, United Kingdom.
authors.forename: G J
authors.initials: GJ
authors.lastname: Prescott
authors.affiliation: Division of Applied Health Sciences, University of Aberdeen, United Kingdom. Electronic address: k.wilde@abdn.ac.uk.
authors.forename: K
authors.initials: K
authors.lastname: Wilde
authors.affiliation: Obstetric Epidemiology, Division of Applied Health Sciences, University of Aberdeen, United Kingdom. Electronic address: sohinee.bhattacharya@abdn.ac.uk.
authors.forename: S
authors.initials: S
authors.lastname: Bhattacharya
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008498:Medical Record Linkage; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: Chronic kidney disease; Gestational hypertension; Preeclampsia; Record linkage