Women with a history of preeclampsia should be monitored for the onset and progression of chronic kidney disease.

This Practice Point commentary discusses a recent paper in which Vikse et al. demonstrated that history of preeclampsia is a marker for an increased risk of end-stage renal disease (ESRD). Among women with preeclampsia, giving birth to a low-birth-weight or preterm infant further increased the relative risk of ESRD, which suggests that more-severe preeclampsia might be a marker for an even higher risk of ESRD. Although the precise mechanisms for the association between preeclampsia and ESRD were not demonstrated, the common risk factors of preeclampsia and chronic kidney disease might explain these observations; alternatively, preeclampsia itself might induce renal injury by suppressing the activity of renoprotective angiogenic factors. This commentary emphasizes that although the absolute risk of developing ESRD is low, women with a history of preeclampsia should undergo renal follow-up (including estimation of glomerular filtration rate, measurement of blood pressure and quantification of proteinuria), a practice which might also decrease risk of cardiovascular disease.