Vannevel V, et al. - Researchers here investigated if preeclampsia is associated with kidney function decline either during the pregnancy or in the long term. After renal transplantation, preeclampsia often complicated pregnancies, however, it was not found to be associated with long-term renal dysfunction or graft loss.

Methods

• An international multicenter retrospective cohort study was undertaken.
• Researchers collected renal function at conception, pregnancy outcomes, and short- and long-term graft outcomes for women who were pregnant after renal transplantation and had transplant and obstetric care at the participating centers.
• Only the last pregnancy was included in women who had multiple pregnancies during the study period.
• They performed univariate and multivariable analyses.

Results

• Pregnancy outcomes and long-term renal outcomes were retrieved for 52 women.
• Among them, 27% patients presented with chronic hypertension at baseline.
• At start of pregnancy, mean estimated glomerular filtration rate (GFR) was 52.4±17.5 mL/min/1.73 m².
• At delivery, mean estimated GFR was 47.6±21.6 mL/min/1.73 m², which was significantly lower than at conception (P=.03).
• Preeclampsia developed in 20 women (38%).
• In multivariable analysis, a 10.7-mL/min/1.73 m² higher drop in estimated GFR was observed among women who developed preeclampsia between conception and delivery compared to women who did not develop preeclampsia (P=.02).
• At a median of 5.8 years, researchers obtained long-term estimated GFR follow-up (range 1.3–27.5 years).
• At last follow-up, mean estimated GFR was 38±23 mL/kg/1.73 m².
• Graft loss was reported in 17 women (33%) over the follow-up period.
• In women with and without preeclampsia in their last pregnancy, incidence of graft loss was similar (30% and 34%, respectively; P=.99).
• Multivariable analysis revealed that the decrease in estimated GFR between conception and last follow-up was similar in women who experienced preeclampsia during pregnancy and those who did not (difference -2.69 mL/min/1.73 m², P=.65).