- WEDNESDAY, Aug. 20 (HealthDay News) — Women who've experienced
the pregnancy complication known as preeclampsia face a much greater risk
of end-stage renal disease, new research suggests.

In fact, says the report in the Aug. 21 issue of the New England
Journal of Medicine, the rate of end-stage renal disease (ESRD) was
between 3.2 and 15.5 times greater for women who had preeclampsia in
pregnancy.

“If you have had preeclampsia, you should be aware that you are at
increased risk for renal and cardiovascular disease, and you should try to
reduce that risk,” said study author Dr. Bjorn Vikse, a researcher at the
University of Bergen in Norway.

Preeclampsia is a complication of pregnancy characterized by high blood
pressure, protein in the urine, and swelling, as well as more serious
problems, according to the National Institutes of Health. Symptoms
resolve when the baby is born.

“Historically, the thought was that after delivery, everything was
fine. But preeclampsia isn't benign, and it may initiate a cascade of
damage that takes years to develop into clinically relevant renal
disease,” said Dr. Robert Provenzano, chief of nephrology at St. John
Hospital and Medical Center in Detroit.

“The take-home message from this study is that any young woman who has
had any variant of preeclampsia and eclampsia needs to be monitored for
ongoing or recurrent kidney disease, high blood pressure and diabetes,”
Provenzano said.

The current study looked at data from the Norwegian Medical Birth
Registry, which has information on all births in Norway since 1967. This
study included 570,433 women who gave birth between 1967 and 1991, and
data from up to three pregnancies was included.

End-stage renal disease developed in 477 women, an average of 17 years
after delivery.

In women who'd been pregnant one or more times, those who experienced
preeclampsia during the first pregnancy had a 4.7 times greater risk of
developing ESRD. For women who'd been pregnant two or more times,
preeclampsia during the first pregnancy resulted in a 3.2 times higher
risk of ESRD. Women who'd been pregnant three or more times, and who'd had
preeclampsia during two or three of those pregnancies had the highest
risk — 15.5 times that of women who'd never had preeclampsia.

Additionally, the study found that when the baby was born early or had
a low birth weight, the mother was more likely to develop ESRD later in
life.

Vikse said the increased risk of ESRD may be a result of damage that
occurs during a pregnancy with preeclampsia, or it may be that risk
factors for both, such as increased body-mass index and elevated blood
pressure, may have already been present before the pregnancy and
contributed to the preeclampsia and later kidney disease.

The one bright spot in the study was that the overall risk of ESRD is
quite low. In an accompanying editorial, authors from Massachusetts
General Hospital wrote, “Indeed, the likelihood that chronic renal failure
did not develop, even among women with three previous episodes of
preeclampsia, was greater than 99 percent.”

But that doesn't mean you should just forget that you've had
preeclampsia, advised Provenzano. “It's critical that doctors and patients
understand that there is now a linkage between preeclampsia and ESRD. For
women who've had preeclampsia, this is a reason to increase your
sensitivity to healthy living and not add to your risk. Keep your weight
down, avoid smoking, and avoid drinking too much. Also, check for diabetes
and blood pressure at least once a year,” he recommended.

More information

To learn more about preeclampsia, visit the American Academy of Family
Physicians.