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Chronic kidney disease in preeclamptic patients: not found unless searched for—Is a nephrology evaluation useful after an episode of preeclampsia?

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Abstract

Background

Preeclampsia (PE) and chronic kidney disease (CKD) are linked by an only partially known cause-effect relationship. Knowledge on prevalence of CKD in PE patients is needed for evaluating the diagnostic yield of nephrology work-up after PE.

Methods

The study was undertaken in the Centre Hospitalier Le Mans (CHM), setting of tertiary level obstetric service (about 3500 deliveries/year). PE was identified on hospital’s discharge codes; after review, the study included 99 patients, 36 of which were also evaluated in Nephrology. A descriptive analysis was performed as appropriate. Logistic multiple regression tested the outcome “CKD diagnosis”; covariates that emerged as significant were selected; only singletons were included. Analysis was performed in SPSS. The ethics committee of the CHM approved the study.

Results

Prevalence of CKD was 14%; CKD was in stage 1 in 8/14 (57%); 5 patients were in stage 2 (36%), 1 in stage 3 (7%). CKD was known or acknowledged in 1 case only. Diagnoses included reflux nephropathy-other malformations (5 cases), kidney stones-chronic pyelonephritis (3), PKD (1), interstitial nephropathy (2), diabetic nephropathy (1), albuminuria in metabolic syndrome (2). At the logistic regression analysis, preterm delivery [OR 7.849 (1.667–36.968)] and a baby normal for gestational age [> 10th centile; OR 6.193 (1.400–27.394)] were significantly correlated with the diagnosis of CKD.

Conclusions

Within the limits of a single-center study, our data quantify CKD as common in PE women and suggest the presence of a “CKD phenotype” characterised by preterm delivery and adequate growth, implying that CKD is compatible with good placental function up to the last phase of pregnancy.

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Acknowledgements

To Susan Finnel for her careful language correction.

Funding

No funding was obtained for this study. The Centre Hospitalier Le Mans supported language correction and publication fees.

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Authors and Affiliations

  1. Centre Hospitalier Le Mans, Avenue Roubillard 196, 7200, Le Mans, France

    Zineb Filali Khattabi, Antioco Fois, Antoine Chatrenet, Delphine Laroche, Marie Therese Cheve & Giorgina Barbara Piccoli

  2. Ibn Rochd University Hospital, Casablanca, Morocco

    Zineb Filali Khattabi

  3. Dipartimento di Chirurgia, University of Torino, Turin, Italy

    Marilisa Biolcati & Rossella Attini

  4. Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Turin, Italy

    Giorgina Barbara Piccoli

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  1. Zineb Filali Khattabi
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  2. Marilisa Biolcati
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Contributions

Study design: GBP, ZFK; RA; extraction of data: ZFK, AF, AC; statistical analysis: MB; patient follow-up: nephrology GBP, AF, ZFK; obstetrics: DL, MTC; drafting of paper: GBP, ZFK, MTC; all authors read and approved the final version.

Corresponding author

Correspondence to Giorgina Barbara Piccoli.

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Conflict of interest

None of the authors has any conflict of interest.

Ethical approval

The study protocol was approved by the ethics committee of the Centre Hospitalier Le Mans (session of 14/06/2018).

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Informed consent was obtained from all individual participants included in the study.

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Filali Khattabi, Z., Biolcati, M., Fois, A. et al. Chronic kidney disease in preeclamptic patients: not found unless searched for—Is a nephrology evaluation useful after an episode of preeclampsia?. J Nephrol 32, 977–987 (2019). https://doi.org/10.1007/s40620-019-00629-8

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