Longer Term Effect of Pregnancy Induced Hypertension on Chronic Kidney Disease and Hypertension

Abstract

Background: Pregnancy-Induced-Hypertension (PIH) is claimed to create greater risk of hypertension (HTN) and chronic-kidney- diseases (CKD) at later life of the women. Objective: To explore what proportion of women with history of PIH develop HTN and CKD in later stages after delivery and, to study the interrelation of HTN and CKD with socio-demographic, anthropometric and biochemical risk factors. Methods: Under an observational case-control design 133 women with previous history of PIH [PIH group; Age(yrs), Median(range) 31(25–45), and BMI [(kg/m2, (Mean ± SD)(25.2 ± 2.1)] were compared with 113 women without history of PIH (Non-PIH group), Age(yrs) Median(range) 34(25–45), and BMI [(kg/m2, Mean ± SD) (25.8 ± 2.9)] for the development of HTN (SBP > 130 mmHg; DBP > 90 mmHg; or MBP > 105 mmHg) and CKD [as measured by total-urinary-protein and elevated urinary-protein-creatinine ratio (UPCR)]. Clinical and anthropometric parameters were measured by standard techniques, lipids by enzymatic-colorimetric method, urinary total protein by pyrogallol-red method, urinary-protein by strip method and urinary-creatinine was measured by alkaline-picrate method. Results: Out of the 133 women in PIH group 43(32.3%) developed HTN and 41 (30.8%) developed CKD in the Non-PIH group 17(15%) developed HTN and 16 (14.2%) developed CKD. SBP, DBP and MBP, all were significantly higher in the PIH compared to the Non-PIH group. PIH group had 4 times higher chance of developing HTN (Odds Ratio 4.2). In parallel to the findings on HTN, PIH group showed a significantly higher proportion of CKD [Proteinuric 10(7.5%)]. Both urinary-total-protein and UPCR were significantly higher in PIH group as compared to Non-PIH group. The PIH group had almost 3 times chance of developing CKD compared to the Non-PIH group. A significant correlation of MBP was found with UPCR, Total-cholesterol and serum-uric-acid. UPCR was also correlated with SBP. On logistic regression, MBP had a positive association with UPCR and Uric Acid. Conclusions: PIH-group is more vulnerable compare to Non-PIH group.