8 SYSTOLIC BLOOD PRESSURE AS RISK FACTOR ASSOCIATED WITH PERSISTING PROTEINURIA AFTER DELIVERY IN WOMEN WITH PREECLAMPSIA

Abstract

Background: Recent researches have established strong association between preeclampsia and end-stage renal disease (ESRD) in later life, however, the point where renal complications commonly begin after post-partum period is not clearly known. Early identification of abnormal kidney parameter in formerly preeclamptic women may potentially halt disease progression and prevent future irreversible damage. This study was conducted to evaluate factors associated with persistent renal endothelial damage reflected as proteinuria 3 months after delivery. Methods: This was a hospital-based matched case-control study conducted in Dr. Soetomo and Universitas Airlangga Hospital, Surabaya, Indonesia, between January to October 2021 involving 64 women with preeclampsia. The case-group included women with proteinuria 3 months post-partum (26 subjects) while control-group included those without proteinuria (38 subjects). Potential risk factors for persisting proteinuria were assessed through interview and medical record review. Odds ratio (OR) and their corresponding 95% confidence intervals (CI) were calculated. Results: Systolic blood pressure (SBP) obtained at diagnosis of preeclampsia was the only significant risk factor for persistent proteinuria 3 months after delivery found in this study (p=0.032). The women in the case and control group had a mean SBP of 168.27 ± 17.45 mmHg and 155.34 ± 13.86 mmHg respectively. From the Receiver Operating Characteristic (ROC) analysis, we discovered cut off point in 169 mmHg (OR 6.6; 95% CI = 1.96-22.24) with the value of area under the curves (AUC) 0.719. Conclusion: This study showed that elevated SBP is a significant risk factor for persisting proteinuria 3 months after delivery in preeclampsia patients. Recognizing this risk factor helps us in prioritizing patients who may benefit from tighter monitoring in post-partum period.