Elizabeth W Dehmer1, Milind A Phadnis2, Erica P Gunderson3, Cora E Lewis4, Kirsten Bibbins-Domingo5, Stephanie M Engel6, Michele Jonsson Funk6, Holly Kramer7, Abhijit V Kshirsagar8, Gerardo Heiss6. 1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: weavereg@med.unc.edu. 2. Department of Biostatistics, University of Kansas School of Medicine, Kansas City, KS. 3. Division of Research, Kaiser Permanente Northern California, Oakland, CA. 4. Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL. 5. Department of Medicine, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA. 6. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. 7. Division of Nephrology and Hypertension, Department of Public Health Sciences and Medicine, Loyola Medical Center, Maywood, IL. 8. UNC Kidney Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions. STUDY DESIGN: Prospective cohort. SETTING & PARTICIPANTS: Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks' gestation, and had kidney function measurements during 25 years of follow-up. PREDICTOR: GDM was self-reported by women for each pregnancy. OUTCOMES: CKD was defined as the development of estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or urine albumin-creatinine ratio ≥ 25mg/g at any one CARDIA examination in years 10, 15, 20, or 25. MEASUREMENTS: HRs for developing CKD were estimated for women who developed GDM versus women without GDM using complementary log-log models, adjusting for prepregnancy age, systolic blood pressure, dyslipidemia, body mass index, smoking, education, eGFR, fasting glucose concentration, physical activity level (all measured at the CARDIA examination before the first pregnancy), race, and family history of diabetes. We explored for an interaction between race and GDM. RESULTS: During a mean follow-up of 20.8 years, 105 of 820 (12.8%) women developed CKD, predominantly increased urine albumin excretion (98 albuminuria only, 4 decreased eGFR only, and 3 both). There was evidence of a GDM-race interaction on CKD risk (P=0.06). Among black women, the adjusted HR for CKD was 1.96 (95% CI, 1.04-3.67) in GDM compared with those without GDM. Among white women, the HR was 0.65 (95% CI, 0.23-1.83). LIMITATIONS: Albuminuria was assessed by single untimed measurements of urine albumin and creatinine. CONCLUSIONS: GDM is associated with the subsequent development of albuminuria among black women in CARDIA.
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions. STUDY DESIGN: Prospective cohort. SETTING & PARTICIPANTS: Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks' gestation, and had kidney function measurements during 25 years of follow-up. PREDICTOR: GDM was self-reported by women for each pregnancy. OUTCOMES: CKD was defined as the development of estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or urine albumin-creatinine ratio ≥ 25mg/g at any one CARDIA examination in years 10, 15, 20, or 25. MEASUREMENTS: HRs for developing CKD were estimated for women who developed GDM versus women without GDM using complementary log-log models, adjusting for prepregnancy age, systolic blood pressure, dyslipidemia, body mass index, smoking, education, eGFR, fasting glucose concentration, physical activity level (all measured at the CARDIA examination before the first pregnancy), race, and family history of diabetes. We explored for an interaction between race and GDM. RESULTS: During a mean follow-up of 20.8 years, 105 of 820 (12.8%) women developed CKD, predominantly increased urine albumin excretion (98 albuminuria only, 4 decreased eGFR only, and 3 both). There was evidence of a GDM-race interaction on CKD risk (P=0.06). Among black women, the adjusted HR for CKD was 1.96 (95% CI, 1.04-3.67) in GDM compared with those without GDM. Among white women, the HR was 0.65 (95% CI, 0.23-1.83). LIMITATIONS: Albuminuria was assessed by single untimed measurements of urine albumin and creatinine. CONCLUSIONS: GDM is associated with the subsequent development of albuminuria among black women in CARDIA.
Authors: Ron T Gansevoort; Kunihiro Matsushita; Marije van der Velde; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh Journal: Kidney Int Date: 2011-02-02 Impact factor: 10.612
Authors: S Friedman; D Rabinerson; J Bar; A Erman; M Hod; B Kaplan; G Boner; J Ovadia Journal: Acta Obstet Gynecol Scand Date: 1995-05 Impact factor: 3.636
Authors: Allon N Friedman; Allon Friedman; David Marrero; Yong Ma; Ronald Ackermann; K M Venkat Narayan; Elizabeth Barrett-Connor; Karol Watson; William C Knowler; Edward S Horton Journal: Diabetes Care Date: 2008-09-16 Impact factor: 19.112
Authors: Maleesa M Pathirana; Zohra S Lassi; Anna Ali; Margaret A Arstall; Claire T Roberts; Prabha H Andraweera Journal: Endocrine Date: 2020-09-15 Impact factor: 3.633
Authors: Aparna S Ajjarapu; Stefanie N Hinkle; Jing Wu; Mengying Li; Shristi Rawal; Ellen C Francis; Liwei Chen; Georgia Pitsava; Anne A Bjerregaard; Louise G Grunnet; Allan Vaag; Yeyi Zhu; Ronald C W Ma; Peter Damm; James L Mills; Sjurdur F Olsen; Cuilin Zhang Journal: J Ren Nutr Date: 2020-01-17 Impact factor: 3.655
Authors: Elizabeth M Hendren; Monica L Reynolds; Laura H Mariani; Jarcy Zee; Michelle M O'Shaughnessy; Andrea L Oliverio; Nicholas W Moore; Peg Hill-Callahan; Dana V Rizk; Salem Almanni; Katherine E Twombley; Emily Herreshoff; Carla M Nester; Michelle A Hladunewich Journal: J Clin Med Date: 2019-02-03 Impact factor: 4.241
Authors: Colleen M Norris; Cindy Y Y Yip; Kara A Nerenberg; Marie-Annick Clavel; Christine Pacheco; Heather J A Foulds; Marsha Hardy; Christine A Gonsalves; Shahin Jaffer; Monica Parry; Tracey J F Colella; Abida Dhukai; Jasmine Grewal; Jennifer A D Price; Anna L E Levinsson; Donna Hart; Paula J Harvey; Harriette G C Van Spall; Hope Sarfi; Tara L Sedlak; Sofia B Ahmed; Carolyn Baer; Thais Coutinho; Jodi D Edwards; Courtney R Green; Amy A Kirkham; Kajenny Srivaratharajah; Sandra Dumanski; Lisa Keeping-Burke; Nadia Lappa; Robert D Reid; Helen Robert; Graeme Smith; Michelle Martin-Rhee; Sharon L Mulvagh Journal: J Am Heart Assoc Date: 2020-02-17 Impact factor: 5.501
Authors: Peter M Barrett; Fergus P McCarthy; Marie Evans; Marius Kublickas; Ivan J Perry; Peter Stenvinkel; Karolina Kublickiene; Ali S Khashan Journal: PLoS One Date: 2022-03-10 Impact factor: 3.240