Adebamike A Oshunbade1, Seth T Lirette2, B Gwen Windham3, Tariq Shafi4, Arsalan Hamid1, Semiu O Gbadamosi5, Adrienne Tin3, Wondwosen K Yimer2, Martin Tibuakuu6, Donald Clark1, Daisuke Kamimura7, Elizabeth A Lutz8, Robert J Mentz9, Ervin R Fox1, Javed Butler1, Kenneth R Butler3, Vesna D Garovic10, Stephen T Turner11, Thomas H Mosley3, Michael E Hall12. 1. University of Mississippi Medical Center, Department of Medicine, Division of Cardiology, Jackson, MS. 2. Department of Data Sciences, Jackson, MS. 3. Division of Geriatrics, Jackson, MS; MIND Center, University of Mississippi Medical Center, Jackson, MS. 4. Division of Nephrology and Hypertension, Jackson, MS. 5. Florida International University, Department of Epidemiology, Miami, FL. 6. Johns Hopkins University School of Medicine, Department of Cardiology, Baltimore, MD. 7. University of Mississippi Medical Center, Department of Medicine, Division of Cardiology, Jackson, MS; Yokohama City University Graduate School of Medicine, Department of Medical Science and Cardiorenal Medicine, Yokohama, Japan. 8. Department of Obstetrics and Gynecology, Jackson, MS. 9. Duke University Medical Center, Duke Clinical Research Institute, Durham, NC. 10. Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN; Department of Obstetrics and Gynecology, Rochester, MN. 11. Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN. 12. University of Mississippi Medical Center, Department of Medicine, Division of Cardiology, Jackson, MS. Electronic address: mehall@umc.edu.
Abstract
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.
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.
Authors: Daisuke Kamimura; Takeki Suzuki; Wanmei Wang; Matthew deShazo; John E Hall; Michael D Winniford; Iftikhar J Kullo; Thomas H Mosley; Kenneth R Butler; Michael E Hall Journal: Hypertens Res Date: 2018-06-15 Impact factor: 3.872
Authors: Barry I Freedman; Stephanie R Beck; Stephen S Rich; Gerardo Heiss; Cora E Lewis; Stephen Turner; Michael A Province; Karen L Schwander; Donna K Arnett; Beverly G Mellen Journal: Hypertension Date: 2003-08-18 Impact factor: 10.190