Diabetes research and clinical practice · 2025
Pregestational and gestational diabetes mellitus and risk of postpartum kidney disease: A retrospective cohort study.
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Backal Amy, Vasudevan Swathi, Lee Rachel, Rosenfeld Emily B, Ananth Cande V
Аннотация
BACKGROUND: Globally, rates of Pregestational (PGDM) and Gestational Diabetes Mellitus (GDM) are rising, but how they affect the risks of kidney disease in the postpartum period remains poorly understood.
METHODS: The Nationwide Readmissions Database (2010-2020) was utilized to design a retrospective cohort study of women aged 15-54. Using ICD codes, deliveries complicated by PGDM and GDM were identified. Primary readmission outcomes for kidney disease in the same calendar year of delivery were assessed. Women who were hospitalized for any kidney disease before delivery were excluded. The Cox regression model was used to estimate the risk of kidney disease readmissions associated with PGDM and GDM.
FINDINGS: Compared to women without diabetes, the adjusted hazard ratio [HR] for Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) among women with PGDM were 9.07 (95% confidence interval [CI], 8.44, 9.75) and 20.73 (95% CI, 18.00, 23.87), respectively. The corresponding risks for women with GDM were 1.25 (95% CI, 1.16, 1.35) and 1.34 (95% CI, 1.14, 1.58), respectively.
INTERPRETATION: The substantially increased risk of postpartum readmission for kidney disease associated with PGDM and, to a lesser extent, with GDM underscores the need for improved surveillance for kidney complications in women with PGDM and GDM.
METHODS: The Nationwide Readmissions Database (2010-2020) was utilized to design a retrospective cohort study of women aged 15-54. Using ICD codes, deliveries complicated by PGDM and GDM were identified. Primary readmission outcomes for kidney disease in the same calendar year of delivery were assessed. Women who were hospitalized for any kidney disease before delivery were excluded. The Cox regression model was used to estimate the risk of kidney disease readmissions associated with PGDM and GDM.
FINDINGS: Compared to women without diabetes, the adjusted hazard ratio [HR] for Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) among women with PGDM were 9.07 (95% confidence interval [CI], 8.44, 9.75) and 20.73 (95% CI, 18.00, 23.87), respectively. The corresponding risks for women with GDM were 1.25 (95% CI, 1.16, 1.35) and 1.34 (95% CI, 1.14, 1.58), respectively.
INTERPRETATION: The substantially increased risk of postpartum readmission for kidney disease associated with PGDM and, to a lesser extent, with GDM underscores the need for improved surveillance for kidney complications in women with PGDM and GDM.