TY - JOUR
T1 - Hypertensive Diseases in Pregnancy and Kidney Function Later in Life
T2 - The Genetic Epidemiology Network of Arteriopathy (GENOA) Study
AU - Oshunbade, Adebamike A.
AU - Lirette, Seth T.
AU - Windham, B. Gwen
AU - Shafi, Tariq
AU - Hamid, Arsalan
AU - Gbadamosi, Semiu O.
AU - Tin, Adrienne
AU - Yimer, Wondwosen K.
AU - Tibuakuu, Martin
AU - Clark, Donald
AU - Kamimura, Daisuke
AU - Lutz, Elizabeth A.
AU - Mentz, Robert J.
AU - Fox, Ervin R.
AU - Butler, Javed
AU - Butler, Kenneth R.
AU - Garovic, Vesna D.
AU - Turner, Stephen T.
AU - Mosley, Thomas H.
AU - Hall, Michael E.
N1 - Funding Information:
Grant Support: This work was supported in part by grants U01-HL054463 (THM) from the National Heart, Lung, and Blood Institute of the National Institutes of Health . MEH has been supported by 1K08DK099415 from the National Institute of Diabetes and Digestive and Kidney Diseases and P20GM10357 and 5U54GM115428 from the National Institute of General Medical Sciences . STL is partially supported by the Mississippi Center for Clinical and Translational Research and Mississippi Center of Excellence in Perinatal Research COBRE funded by the National Institute of General Medical Sciences of the National Institutes of Health under Award Numbers 5U54GM115428 and P20GM121334 . VDG was supported by the grant R01HL136348 from the National Institutes of Health . STT was supported by the grant R01DK073537 from the National Institutes of Health R01DK073537 .
Publisher Copyright:
© 2021
PY - 2022/1
Y1 - 2022/1
N2 - Objective: To evaluate the relationship between hypertensive diseases in pregnancy and kidney function later in life. Methods: We evaluated measured glomerular filtration rate (mGFR) using iothalamate urinary clearance in 725 women of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Women were classified by self-report as nulliparous (n=62), a history of normotensive pregnancies (n=544), a history of hypertensive pregnancies (n=102), or a history of pre-eclampsia (n=17). We compared adjusted associations among these four groups with mGFR using generalized estimating equations to account for familial clustering. Chronic kidney disease (CKD) was defined as mGFR of less than 60 mL/min per 1.73 m2 or urinary albumin-creatinine ratio (UACR) greater than or equal to 30 mg/g. Results: Among women with kidney function measurements (mean age, 59±9 years, 52.9% African American), those with a history of hypertensive pregnancy had lower mGFR (–4.66 ml/min per 1.73 m2; 95% CI, -9.12 to -0.20) compared with women with a history of normotensive pregnancies. Compared with women with a history of normotensive pregnancies, women with a history of hypertensive pregnancy also had higher odds of mGFR less than 60 ml/min per 1.73 m2 (odds ratio, 2.09; 95% CI, 1.21 to 3.60). Additionally, women with a history of hypertensive pregnancy had greater odds for chronic kidney disease (odds ratio, 4.89; 95% CI, 1.55 to 15.44), after adjusting for age, race, education, smoking history, hypertension, body mass index, and diabetes. Conclusion: A history of hypertension in pregnancy is an important prognostic risk factor for kidney disease. To our knowledge, this is the first and largest investigation showing the association between hypertensive diseases in pregnancy and subsequent kidney disease using mGFR in a large biracial cohort.
AB - Objective: To evaluate the relationship between hypertensive diseases in pregnancy and kidney function later in life. Methods: We evaluated measured glomerular filtration rate (mGFR) using iothalamate urinary clearance in 725 women of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Women were classified by self-report as nulliparous (n=62), a history of normotensive pregnancies (n=544), a history of hypertensive pregnancies (n=102), or a history of pre-eclampsia (n=17). We compared adjusted associations among these four groups with mGFR using generalized estimating equations to account for familial clustering. Chronic kidney disease (CKD) was defined as mGFR of less than 60 mL/min per 1.73 m2 or urinary albumin-creatinine ratio (UACR) greater than or equal to 30 mg/g. Results: Among women with kidney function measurements (mean age, 59±9 years, 52.9% African American), those with a history of hypertensive pregnancy had lower mGFR (–4.66 ml/min per 1.73 m2; 95% CI, -9.12 to -0.20) compared with women with a history of normotensive pregnancies. Compared with women with a history of normotensive pregnancies, women with a history of hypertensive pregnancy also had higher odds of mGFR less than 60 ml/min per 1.73 m2 (odds ratio, 2.09; 95% CI, 1.21 to 3.60). Additionally, women with a history of hypertensive pregnancy had greater odds for chronic kidney disease (odds ratio, 4.89; 95% CI, 1.55 to 15.44), after adjusting for age, race, education, smoking history, hypertension, body mass index, and diabetes. Conclusion: A history of hypertension in pregnancy is an important prognostic risk factor for kidney disease. To our knowledge, this is the first and largest investigation showing the association between hypertensive diseases in pregnancy and subsequent kidney disease using mGFR in a large biracial cohort.
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U2 - 10.1016/j.mayocp.2021.07.018
DO - 10.1016/j.mayocp.2021.07.018
M3 - Article
C2 - 34565606
AN - SCOPUS:85115787002
SN - 0025-6196
VL - 97
SP - 78
EP - 87
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 1
ER -