Close association between preeclampsia and chronic kidney disease in middle-aged women

R epidemiological studies have demonstrated a relationship between preeclampsia and later clinical kidney disease. There are, however, little data available regarding these relationships. In the present study, we examined the link between a past history of preeclampsia and biopsy proven chronic kidney disease in middle-aged women between 35 and 65 years old (51+1 years). One hundred twenty-seven women who underwent renal biopsy between 1995 and 2005 were analyzed. Of the 127, 32 patients had a past history of preeclampsia: 12 patients had focal segmental glomerulosclerosis, 10 had IgA nephropathy, and 10 had nephrosclerosis. In contrast to the women with a past history of preeclampsia, among women without a past history of preeclampsia, 26 patients had IgA nephropathy, 20 had minimal change in nephritic syndrome, 6 had nephrosclerosis, 6 had membranous nephropathy, 5 had lupus nephritis, 5 had diabetic nephropathy, and 27 had various other nephropathies. Among women without past history of preeclampsia, none had focal segmental glomerulosclerosis. There were no significant differences in age, the levels of serum creatinine, and urinary protein excretion between the two groups. In comparing IgA nephropathy of the two groups, the mean systolic blood pressure was significantly higher in women with a past history of preeclampsia; however, there was no significant difference in the systolic blood pressure of women between with nephrosclerosis in the two groups. In this study, first; one quarter of all the women who had renal biopsy had preeclampsia. Second, IgA and nephrosclerosis were found in both groups, indicating that these two diseases may not directly relate with preeclampsia. Third, focal segmental nephrosclerosis might be a more specific nephropathy linked with preeclampsia. In conclusion, women with a past history of preeclampsia should be followed cautiously after childbirth in regard to nephropathy.