The dilemma of chronic kidney disease and end-stage kidney disease following pre-eclampsia: a literature review and meta-analysis.
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BORIS DOI
Publisher DOI
PubMed ID
40483331
Description
Purpose
Pre-eclampsia (PE) is a pregnancy-related multisystem syndrome, characterized by the sudden onset of hypertension after 20 weeks' gestation. Although previous studies and meta-analyses found an association between pre-eclampsia and chronic kidney disease or end-stage kidney disease later in life, it remains unclear whether this relationship is causal. Furthermore, research conducted to date has not consistently excluded women with chronic hypertension and/or kidney disease prior to pregnancy, indicating a possible selection bias. Therefore, we undertook a systematic review of the updated literature on renal outcomes in women who were healthy prior to pregnancy and experienced pre-eclampsia.
Methods
We searched PubMed-MEDLINE and Embase for eligible studies. We included retrospective and prospective studies involving healthy women with pre-eclampsia and reporting kidney outcomes. Of the 2,796 titles originally screened, 9 studies met our inclusion criteria. A random effects meta-analytic model was used for statistical analysis.
Results
A statistically significant increase in the risk of developing chronic kidney disease and end-stage kidney disease later in life following pre-eclampsia was found (meta-analytic risk ratios [95% confidence interval]: 1.83 [1.16-2.89] and 8.96 [4.94-16.23], respectively), with high statistical heterogeneity. However, the only prospective study did not find a significant association between pre-eclampsia and chronic kidney disease.
Conclusions
Although a significant association was identified, its clinical relevance and causality remain unclear. Postpartum medical investigation in women affected by pre-eclampsia is essential, but long-term follow-up may not be indicated in the absence of underlying conditions. Only prospective studies could clarify the relationship between pre-eclampsia and kidney disease in women who were healthy before pregnancy.
Pre-eclampsia (PE) is a pregnancy-related multisystem syndrome, characterized by the sudden onset of hypertension after 20 weeks' gestation. Although previous studies and meta-analyses found an association between pre-eclampsia and chronic kidney disease or end-stage kidney disease later in life, it remains unclear whether this relationship is causal. Furthermore, research conducted to date has not consistently excluded women with chronic hypertension and/or kidney disease prior to pregnancy, indicating a possible selection bias. Therefore, we undertook a systematic review of the updated literature on renal outcomes in women who were healthy prior to pregnancy and experienced pre-eclampsia.
Methods
We searched PubMed-MEDLINE and Embase for eligible studies. We included retrospective and prospective studies involving healthy women with pre-eclampsia and reporting kidney outcomes. Of the 2,796 titles originally screened, 9 studies met our inclusion criteria. A random effects meta-analytic model was used for statistical analysis.
Results
A statistically significant increase in the risk of developing chronic kidney disease and end-stage kidney disease later in life following pre-eclampsia was found (meta-analytic risk ratios [95% confidence interval]: 1.83 [1.16-2.89] and 8.96 [4.94-16.23], respectively), with high statistical heterogeneity. However, the only prospective study did not find a significant association between pre-eclampsia and chronic kidney disease.
Conclusions
Although a significant association was identified, its clinical relevance and causality remain unclear. Postpartum medical investigation in women affected by pre-eclampsia is essential, but long-term follow-up may not be indicated in the absence of underlying conditions. Only prospective studies could clarify the relationship between pre-eclampsia and kidney disease in women who were healthy before pregnancy.
Date of Publication
2025-12
Publication Type
Article
Subject(s)
600 - Technology::610 - Medicine & health
Keyword(s)
Healthy women
•
Kidney disease
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Pre-eclampsia
•
Systematic review
Language(s)
en
Additional Credits
Clinic of Nephrology and Hypertension
Series
International Urology and Nephrology
Publisher
Springer
ISSN
1573-2584
0301-1623
Access(Rights)
open.access