HYPERTENSIVE DISORDER OF PREGNANCY AS PREDICTORS OF FUTURE CHRONIC KIDNEY DISEASE IN WOMEN

Abstract

Background: Hypertensive disorders of pregnancy (HDP), including pre-eclampsia, eclampsia, chronic, and gestational hypertension, are known risk factors for long-term renal complications. Data on their association with chronic kidney disease (CKD) in low-resource settings are limited. This study examined whether HDP predicts future CKD in women within one year postpartum.

Methods: A cross-sectional study was conducted on 488 women, including 410 with HDP and 78 normotensive controls from rural settings of pakistan. Clinical records from delivery and postpartum visits at 24 hours, nine weeks, and six months were reviewed. Serum creatinine was used to calculate estimated glomerular filtration rate (eGFR), and CKD was defined as eGFR <60 mL/min/1.73 m² for ≥3 months. Descriptive statistics summarized demographic and clinical characteristics. Chi-square tests assessed associations between HDP and reduced kidney function at each follow-up.

Results: Women with HDP had higher rates of reduced eGFR at all follow-ups compared with controls (24h: p = 0.002; 9 weeks: p = 0.047; 6 months: p = 0.038). CKD prevalence in the HDP group was 6.1% at six months and 7.6% at one year, while no cases occurred in controls. Exposed women were older, had higher gravida and para, lower education, lower income, higher BMI, and higher rates of prior kidney disease.

Conclusion: HDP is significantly associated with reduced kidney function and subsequent CKD within one year postpartum. Routine postpartum renal monitoring is recommended for early identification and management of at-risk women.