Background: Women with hypertensive disorders of pregnancy (HDP) face a five-to ten-fold increased risk of developing kidney disease long-term. However, there are limited data regarding postpartum kidney function.
Aim: To review maternal kidney-related outcomes six and 12 months post-HDP.
Methods: Data from the Blood Pressure Postpartum Study, which included 405 women with HDP, were analysed to assess kidney-related outcomes including serum creatinine, estimated glomerular filtration rate (eGFR) and urine albumin:creatinine ratio (ACR). Outcomes were compared at six and 12 months postpartum for all participants and for subgroups based on kidney disease status, HDP subtype, and lifestyle behaviour change (LBC) intervention. Statistical significance was p-value <0.05.
Results: Of the 405 included women, 16 had confirmed underlying kidney disease. In the overall cohort, median serum creatinine, eGFR and urine ACR were within normal ranges at six- and twelve-months post HDP.
In those without kidney disease, there was a statistically significant but modest reduction in serum creatinine (64 [58-70]umol/L versus 60 [55-67]umol/L) and urine ACR (1 [0.5-2.3]mg/mmol versus 0.8 [0.3 -1.8]mg/mmol) between six and 12 months; p <0.001. There were no significant changes in those with confirmed kidney disease.
In women without pre-existing kidney disease, 18.9% and 14.9% had persistent albuminuria (ACR>3mg/mmol) at six- and twelve-months post-HDP respectively.
Conclusions: In this study of women with HDP, postpartum kidney function largely remained within normal limits, noting the presence of albuminuria in a proportion of women without kidney disease. These findings support current guidelines regarding follow-up in women post-HDP.