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Short- and long-term prognosis of blood pressure and kidney disease in women with a past history of preeclampsia

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Abstract

Little research has been conducted into the long-term effects of preeclampsia, despite its frequent occurrence. The aim of this review is to examine the association between preeclampsia and the development of hypertension and kidney diseases later in life. To achieve this aim, we evaluated three retrospective studies conducted in our department. In the first study, 52 women who suffered from preeclampsia during their first pregnancy were followed for 2 years after delivery for any long-term effects upon blood pressure. In the second study, we evaluated HOMA-R, pulse wave velocity and augmentation index in groups of 48 postmenopausal women with a past history of preeclampsia and 204 postmenopausal women without a past history of preeclampsia. In the third study, we examined the association between a past history of preeclampsia and chronic kidney disease based on biopsy in 127 postmenopausal women. From the first study, although there were no significant differences in age, blood pressure at the onset of preeclampsia, the levels of proteinuria and the birth weight of the child between women who remained hypertensive and those who became normotensive, body mass index was significantly larger in women who remained hypertensive compared to those who were normotensive. In the second study, we found that women with a past history of preeclampsia exhibited insulin resistance combined with reduced vascular elasticity. In the third study, of 32 patients with a past history of preeclampsia, 12 patients exhibited focal segmental glomerulosclerosis, 10 exhibited IgA nephropathy and 10 exhibited nephrosclerosis. In contrast, of the women without a past history of preeclampsia, 26 patients exhibited IgA nephropathy, 20 exhibited a minimal change in nephritic syndrome, 6 exhibited nephrosclerosis, 6 exhibited membranous nephropathy, 5 exhibited lupus nephritis, 5 exhibited diabetic nephropathy, and 27 exhibited various nephropathies. None of the women without a past history of preeclampsia exhibited focal segmental glomerulosclerosis. Taken together with previous results, these findings suggest that hypertension and chronic kidney disease in postmenopausal women are closely associated with a past history of preeclampsia.

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Acknowledgments

We appreciate greatly the kind referral of subjects for this study by Professors H. Takeda, H. Seki, K. Baba, and their colleagues in the General Medical Center for Perinatal Mother-Children, Saitama General Medical Center Hospital.

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Authors and Affiliations

  1. Department of Nephrology, School of Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo Moroyama, Iruma, Saitama, 350-0495, Japan

    Hiromichi Suzuki, Yusuke Watanabe, Hiroshi Arima, Kazuhiro Kobayashi, Yoichi Ohno & Yoshihiko Kanno

Authors
  1. Hiromichi Suzuki
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  2. Yusuke Watanabe
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  3. Hiroshi Arima
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  4. Kazuhiro Kobayashi
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  5. Yoichi Ohno
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  6. Yoshihiko Kanno
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Corresponding author

Correspondence to Hiromichi Suzuki.

Appendix

Appendix

All work was performed according to the Declaration of Helsinki; approval was granted by the institutional ethics committee, and all patients gave written, informed consent.

Definitions of words

Menopause was defined as the absence of a period for 1 year.

Preeclampsia was defined as having maximum blood pressure of at least 140 mmHg systolic and 90 mmHg diastolic accompanied by proteinuria of >0.3 g/24 h prior to labor.

The kidney biopsy diagnosis of glomerular disease was made in accordance with the criteria described in the World Health Organization’s monographs on kidney disease. Consequently, kidney diseases were classified into the following five categories: (1) mesangial proliferative, (2) other immune complex GN (including membranous GN, endocapillary GN, or GN associated with SLE), (3) focal and segmental glomerulosclerosis or minimal GN, (4) other pathological findings at kidney biopsy, acute or chronic interstitial nephritis, benign nephrosclerosis, diabetic nephropathy, vaculitis, thrombotic microangiopathy, crerscentic GN, or other rare kidney disease, and (5) normal findings at kidney biopsy or unrepresentative biopsy specimen.

Statistical analysis

Results were expressed as mean ± SEM. Statistical analysis was performed using the Student’s t test for unpaired samples (or Mann–Whitney tests when applicable for comparison of means. P less than 0.05 was regarded as significant.

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Suzuki, H., Watanabe, Y., Arima, H. et al. Short- and long-term prognosis of blood pressure and kidney disease in women with a past history of preeclampsia. Clin Exp Nephrol 12, 102–109 (2008). https://doi.org/10.1007/s10157-007-0018-1

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  • DOI: https://doi.org/10.1007/s10157-007-0018-1

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