The Burden of Past Hypertensive Disorders of Pregnancy in Females With CKD at Connaught Hospital, Freetown, Sierra Leone

Abstract

Background: Hypertensive disorders of pregnancy (HDP) pose a significant long-term burden on maternal and fetal health globally and it is associated with an increased risk of developing chronic kidney disease (CKD) later in life. The objectives of this study include; The burden of past hypertensive disorders of pregnancy in females with CKD, to determine the relationship between hypertensive disorders of pregnancies and the development of CKD and to identify the risk factors for progression to CKD in patients with history of Hypertensive Disorders of Pregnancy (HDP).

Methods: This study was conducted at Connaught hospital. It is a cross-sectional study of females with CKD, using a structured and pretested questionnaire. Chronic kidney disease is defined as abnormalities of kidney structure or function, present for >3 months, with implications for health," and requires one of two criteria documented or inferred for >3 months: either GFR <60 ml/min/1.73 m2 or markers of kidney damage, including albuminuria.

Results: A total of 30 female patients with CKD were recorded during this study for analysis. Of this cohort, the majority of participants (83.3%) were aged 36-65years. Obstetric data showed that 54.2% were diagnosed with HDP in their second trimester. A vast majority (52.2%) experienced HDP during their second and third pregnancy. Grand multiparity was also commonly seen (26.1%). A high burden of past HDP (76.6%) in CKD females was noted. Preeclampsia was the most common type of HDP (56.5%). Notably, most patients (90.0%) presented with advanced CKD (Stages 4 & 5) at diagnosis.

Conclusion: There is a significant burden of past history of HDP in females with CKD and preeclampsia is the most common type of HDP. Patients presented with advanced CKD.

Key words: Hypertensive disorders of pregnancy (HDP), Chronic kidney disease (CKD), Preeclampsia, Renal outcomes