L. Reiter et al., HYPERTENSION IN PREGNANCY - THE INCIDENCE OF UNDERLYING RENAL-DISEASEAND ESSENTIAL-HYPERTENSION, American journal of kidney diseases, 24(6), 1994, pp. 883-887
The objective of this study was to ascertain the likelihood of underly
ing renal disease or essential hypertension in women diagnosed antepar
tum as having pre-eclampsia. One hundred eighty-six women (antepartum
diagnosis of pre-eclampsia in 87 women and gestational hypertension, a
lso known as ''mild pre-eclampsia'' by other definitions, in 99 women)
in whom no underlying disorder was apparent during pregnancy or the e
arly puerperium were entered into the study. Women were reviewed betwe
en 3 and 60 months postpartum. All patients were assessed by measureme
nt of blood pressure, urinalysis, and phase-contrast urine microscopy,
and those with pre-eclampsia also had plasma urea, electrolyte, and c
reatinine concentrations determined and underwent renal imaging with e
ither intravenous pyelography or ultrasound. The kidneys were also ima
ged in the gestational hypertension group if there was any clinical su
spicion of underlying renal disease on review. Essential hypertension
was diagnosed if systolic blood pressure was higher than 140 mm Hg and
/or diastolic blood pressure was higher than 90 mm Hg after 3 months p
ostpartum and the results of other investigations were normal. Renal d
isease was diagnosed in the presence of abnormal findings on urinalysi
s, urine microscopy, or renal imaging, or by elevated plasma creatinin
e concentration. Seven (8%) of the 87 women with pre-eclampsia had und
erlying disease (essential hypertension, five patients; renal disease,
two patients [one with reflux nephropathy and one with medullary spon
ge kidney]), as did 16 (16%) of the 99 women with gestational hyperten
sion (essential hypertension, 14 patients (14%); renal disease, two pa
tients (2%) [one with medullary sponge kidney and one with thin baseme
nt membrane disease]). Thus, approximately 10% of women with de novo h
ypertension in pregnancy, in whom no underlying disorder is apparent d
uring pregnancy or the immediate puerperium, will be found subsequentl
y to have essential hypertension. Underlying renal disease is uncommon
. (C) 1994 by the National Kidney Foundation, Inc.