Preeclampsia Linked to Long-Term Kidney Disease Risk: Study Findings

Preeclampsia, a systemic disorder affecting 2% to 5% of pregnancies worldwide, isn’t just a temporary complication of pregnancy. New research indicates a lasting impact on cardiovascular and kidney health, with women who experience preeclampsia facing an increased long-term risk of hypertension, heart disease, and cerebrovascular disease. A recent study published in the American Journal of Kidney Diseases sheds light on the connection between preeclampsia and the development of chronic kidney disease (CKD), offering crucial insights into the long-term health risks for these patients.

Researchers led by Jennifer H. Yo, MPH, PhD, conducted a population-based cohort study in Stockholm, Sweden, to determine the risk of CKD among women with a history of preeclampsia compared to those without. The study meticulously tracked a large cohort of over 171,000 pregnancies, with approximately 6% (10,538 pregnancies) being complicated by preeclampsia. The researchers focused on three key outcomes: the incidence of CKD, the incidence of albuminuria (a marker of kidney damage), and a composite outcome combining a significantly reduced estimated glomerular filtration rate (eGFR – a measure of kidney function) and albuminuria.

The study design involved measuring these outcomes on two separate occasions, at least three months apart, to ensure accuracy, and reliability. Participants were carefully matched to account for baseline differences. Women in the preeclampsia group were, on average, slightly older (30 years versus 29 years) and had a marginally higher body mass index (BMI) (24 versus 23 kg/m²) compared to those without preeclampsia. However, after statistical adjustments, the groups were well-balanced regarding these and other baseline characteristics.

Over a median follow-up period of 7.0 years, the study revealed a statistically significant association between preeclampsia and an increased incidence of both albuminuria and reduced eGFR. Specifically, the rate of albuminuria exceeding 300 mg/g was 1.53 per 1,000 person-years in the preeclampsia group, compared to 0.57 per 1,000 person-years in the non-preeclampsia group – a more than twofold increase. Similarly, the rate of eGFR falling below 60 mL/min/1.73 m² was 0.53 per 1,000 person-years in the preeclampsia group, compared to 0.18 per 1,000 person-years in the control group. A composite outcome, encompassing either reduced eGFR or elevated albuminuria, also showed a significant increase in the preeclampsia group (2.43 weighted hazard ratio).

These findings translate to weighted hazard ratios of 2.53 for albuminuria, 2.18 for reduced eGFR, and 2.43 for the composite outcome, all indicating a substantially higher risk for women with a history of preeclampsia. “Our study suggests that preeclampsia is associated with earlier, detectable kidney injury using routine laboratory markers such as urine albumin and eGFR—often long before kidney failure develops,” Dr. Yo concluded.

The implications of this research are significant. Early detection of kidney damage, even before the onset of full-blown CKD, allows for timely intervention with kidney-protective therapies. Albuminuria, in particular, is an actionable marker, meaning that interventions can be implemented to slow or potentially halt the progression of kidney disease. This strengthens the argument for considering a history of preeclampsia as a key risk factor for CKD in adult medical practice.

However, the study authors acknowledge certain limitations. The definition of preeclampsia evolved during the study period, which could introduce some variability. The study population was primarily comprised of women of Nordic descent with access to universal healthcare, potentially limiting the generalizability of the findings to other populations. Kidney function data at the time of pregnancy were not available for all participants, which could have provided additional valuable insights.

Further research, including studies in more diverse populations and investigations into the underlying mechanisms linking preeclampsia to long-term kidney disease, is warranted. A study published in 2025, examining renal disorders following pregnancy, found that women with preeclampsia were 3-9 times more likely to develop end-stage renal disease caused by diabetic nephropathy and glomerulonephritis. This highlights the complex interplay between preeclampsia and other kidney disease pathways.

Despite these limitations, the study provides compelling evidence supporting the need for more systematic postpartum kidney screening for women with a history of preeclampsia. Identifying kidney disease earlier allows for timely intervention and potentially modifies long-term outcomes, ultimately improving the health and well-being of these patients. The findings underscore the importance of viewing preeclampsia not as a solely pregnancy-related condition, but as a potential harbinger of future cardiovascular and kidney health risks.