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Short term sequelae of preeclampsia: a single center cohort study

BACKGROUND: Data on the prevalence of persistent symptoms in the first year after preeclampsia are limited. Furthermore, possible risk factors for these sequelae are poorly defined. We investigated kidney function, blood pressure, proteinuria and urine sediment in women with preeclampsia 6 months af...

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Autores principales: Girsberger, Michael, Muff, Catherine, Hösli, Irene, Dickenmann, Michael Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963132/
https://www.ncbi.nlm.nih.gov/pubmed/29783931
http://dx.doi.org/10.1186/s12884-018-1796-z
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author Girsberger, Michael
Muff, Catherine
Hösli, Irene
Dickenmann, Michael Jan
author_facet Girsberger, Michael
Muff, Catherine
Hösli, Irene
Dickenmann, Michael Jan
author_sort Girsberger, Michael
collection PubMed
description BACKGROUND: Data on the prevalence of persistent symptoms in the first year after preeclampsia are limited. Furthermore, possible risk factors for these sequelae are poorly defined. We investigated kidney function, blood pressure, proteinuria and urine sediment in women with preeclampsia 6 months after delivery with secondary analysis for possible associated clinical characteristics. METHODS: From January 2007 to July 2014 all women with preeclampsia and 6-months follow up at the University Hospital Basel were analyzed. Preeclampsia was defined as new onset of hypertension (≥140/90 mmHg) and either proteinuria or signs of end-organ dysfunction. Hypertension was defined as a blood pressure ≥ 140/90 mmHg or the use of antihypertensive medication. Proteinuria was defined as a protein-to-creatinine ratio in a spot urine > 11 mg/mmol. Urine sediment was evaluated by a nephrologist. Secondary analyses were performed to investigate for possible parameters associated with persistent symptoms after preeclampsia. RESULTS: Two hundred two women were included into the analysis. At a mean time of follow up of 172 days (+/− 39.6) after delivery, mean blood pressure was 124/76 mmHg (+/− 14/11, range 116–182/63–110) and the mean serum-creatinine was 61.8 μmol/l (33–105 μmol/l) (normal < 110 μmol/l). Mean estimated glomerular filtration rate using CKD-EPI was 110.7 mml/min/1.73m(2) (range 59.7–142.4 mml/min/1.73m(2)) (normal > 60 mml/min/1.73m(2)). 20.3% (41/202) had a blood pressure of 140/90 mmHg or higher (mean 143/89 mmHg) or were receiving antihypertensive medication (5.5%, 11/202). Proteinuria was present in 33.1% (66/199) (mean 27.5 mg/mmol). Proteinuria and hypertension was present in 8% (16/199). No active urine sediment (e.g. signs of glomerulonephritis) was observed. Age and gestational diabetes were associated with persistent proteinuria and severe preeclampsia with eGFR decline of ≥ 10 ml/min/1.73m(2). CONCLUSION: Hypertension and proteinuria are common after 6 months underlining the importance of close follow up to identify those women who need further care.
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spelling pubmed-59631322018-06-25 Short term sequelae of preeclampsia: a single center cohort study Girsberger, Michael Muff, Catherine Hösli, Irene Dickenmann, Michael Jan BMC Pregnancy Childbirth Research Article BACKGROUND: Data on the prevalence of persistent symptoms in the first year after preeclampsia are limited. Furthermore, possible risk factors for these sequelae are poorly defined. We investigated kidney function, blood pressure, proteinuria and urine sediment in women with preeclampsia 6 months after delivery with secondary analysis for possible associated clinical characteristics. METHODS: From January 2007 to July 2014 all women with preeclampsia and 6-months follow up at the University Hospital Basel were analyzed. Preeclampsia was defined as new onset of hypertension (≥140/90 mmHg) and either proteinuria or signs of end-organ dysfunction. Hypertension was defined as a blood pressure ≥ 140/90 mmHg or the use of antihypertensive medication. Proteinuria was defined as a protein-to-creatinine ratio in a spot urine > 11 mg/mmol. Urine sediment was evaluated by a nephrologist. Secondary analyses were performed to investigate for possible parameters associated with persistent symptoms after preeclampsia. RESULTS: Two hundred two women were included into the analysis. At a mean time of follow up of 172 days (+/− 39.6) after delivery, mean blood pressure was 124/76 mmHg (+/− 14/11, range 116–182/63–110) and the mean serum-creatinine was 61.8 μmol/l (33–105 μmol/l) (normal < 110 μmol/l). Mean estimated glomerular filtration rate using CKD-EPI was 110.7 mml/min/1.73m(2) (range 59.7–142.4 mml/min/1.73m(2)) (normal > 60 mml/min/1.73m(2)). 20.3% (41/202) had a blood pressure of 140/90 mmHg or higher (mean 143/89 mmHg) or were receiving antihypertensive medication (5.5%, 11/202). Proteinuria was present in 33.1% (66/199) (mean 27.5 mg/mmol). Proteinuria and hypertension was present in 8% (16/199). No active urine sediment (e.g. signs of glomerulonephritis) was observed. Age and gestational diabetes were associated with persistent proteinuria and severe preeclampsia with eGFR decline of ≥ 10 ml/min/1.73m(2). CONCLUSION: Hypertension and proteinuria are common after 6 months underlining the importance of close follow up to identify those women who need further care. BioMed Central 2018-05-21 /pmc/articles/PMC5963132/ /pubmed/29783931 http://dx.doi.org/10.1186/s12884-018-1796-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Girsberger, Michael
Muff, Catherine
Hösli, Irene
Dickenmann, Michael Jan
Short term sequelae of preeclampsia: a single center cohort study
title Short term sequelae of preeclampsia: a single center cohort study
title_full Short term sequelae of preeclampsia: a single center cohort study
title_fullStr Short term sequelae of preeclampsia: a single center cohort study
title_full_unstemmed Short term sequelae of preeclampsia: a single center cohort study
title_short Short term sequelae of preeclampsia: a single center cohort study
title_sort short term sequelae of preeclampsia: a single center cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963132/
https://www.ncbi.nlm.nih.gov/pubmed/29783931
http://dx.doi.org/10.1186/s12884-018-1796-z
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