Preeclampsia and the risk of end-stage renal disease
Preeclampsia and the risk of end-stage renal disease
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DOI：
10.1056/nejmoa0706790
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发表时间：
2008-08-21
影响因子：
158.5
通讯作者：
Iversen, Bjarne M.
中科院分区：
文献类型：
--
作者：
Vikse, Bjorn Egil;Irgens, Lorentz M.;Iversen, Bjarne M.
背景资料：目前尚不清楚先兆子痫是否是随后终末期肾病（ESRD）的风险标志。我们将挪威医学出生登记处的数据（包含自1967年以来挪威所有出生的数据）与挪威肾脏登记处的数据（包含自1980年以来所有接受终末期肾病（ESRD）诊断的患者的数据）相关联，评估一次或多次妊娠中先兆子痫与随后发生ESRD之间的关系。研究人群包括1967年至1991年首次单胎分娩的妇女;我们包括了最多三次怀孕的数据。结果：570，433名妇女中有477名在首次怀孕后平均（+/-SD）17+/-9年（总发病率为每年每10万名妇女3.7例）发生ESRD。在有一次或多次妊娠史的妇女中，第一次妊娠时先兆子痫与终末期肾病的相对风险为4.7（95%置信区间[CI]，3.6 - 6.1）相关。在怀孕两次或两次以上的妇女中，第一次怀孕期间先兆子痫与终末期肾病的相对风险为3.2（95%CI，2.2至4.9），第二次怀孕期间出现先兆子痫，相对风险为6.7（95%CI，4.3至10.6），和先兆子痫在两次怀孕的相对风险为6.4（95%CI，3.0至13.5）。在怀孕三次或三次以上的妇女中，一次怀孕期间先兆子痫与ESRD的相对风险为6.3（95%CI，4.1至9.9）相关，两次或三次怀孕期间先兆子痫与ESRD的相对风险为15.5（95%CI，7.8至30.8）相关。低出生体重或早产儿增加了ESRD的相对风险。调整可能的混杂因素和排除后的妇女谁有肾脏疾病，风湿性疾病，原发性高血压，或糖尿病pregnancy.Conclusions：虽然终末期肾病的绝对风险在妇女谁有先兆子痫是低的，先兆子痫是一个标志，随后的终末期肾病的风险增加。
Background: It is unknown whether preeclampsia is a risk marker for subsequent end-stage renal disease (ESRD).Methods: We linked data from the Medical Birth Registry of Norway, which contains data on all births in Norway since 1967, with data from the Norwegian Renal Registry, which contains data on all patients receiving a diagnosis of end-stage renal disease (ESRD) since 1980, to assess the association between preeclampsia in one or more pregnancies and the subsequent development of ESRD. The study population consisted of women who had had a first singleton birth between 1967 and 1991; we included data from up to three pregnancies.Results: ESRD developed in 477 of 570,433 women a mean (+/-SD) of 17+/-9 years after the first pregnancy (overall rate, 3.7 per 100,000 women per year). Among women who had been pregnant one or more times, preeclampsia during the first pregnancy was associated with a relative risk of ESRD of 4.7 (95% confidence interval [CI], 3.6 to 6.1). Among women who had been pregnant two or more times, preeclampsia during the first pregnancy was associated with a relative risk of ESRD of 3.2 (95% CI, 2.2 to 4.9), preeclampsia during the second pregnancy with a relative risk of 6.7 (95% CI, 4.3 to 10.6), and preeclampsia during both pregnancies with a relative risk of 6.4 (95% CI, 3.0 to 13.5). Among women who had been pregnant three or more times, preeclampsia during one pregnancy was associated with a relative risk of ESRD of 6.3 (95% CI, 4.1 to 9.9), and preeclampsia during two or three pregnancies was associated with a relative risk of 15.5 (95% CI, 7.8 to 30.8). Having a low-birth-weight or preterm infant increased the relative risk of ESRD. The results were similar after adjustment for possible confounders and after exclusion of women who had kidney disease, rheumatic disease, essential hypertension, or diabetes mellitus before pregnancy.Conclusions: Although the absolute risk of ESRD in women who have had preeclampsia is low, preeclampsia is a marker for an increased risk of subsequent ESRD.