Gestational Diabetes Could Predict Future Kidney Damage

Women who develop gestational diabetes during pregnancy have a higher risk for renal dysfunction later in life, especially if they subsequently develop diabetes, according to new research.

This finding emerged from a study of 607 women with and 619 women without gestational diabetes who were enrolled in the 1996-2002 Danish National Birth Cohort. Median follow-up lasted 13 years after index pregnancy.
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Serum creatinine and urinary albumin and creatinine were measured at follow-up. Estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were derived from these measurements.

Results of the study showed that women with a history of gestational diabetes had significantly higher eGFR, regardless of whether they subsequently developed diabetes, compared with women without gestational diabetes or subsequent diabetes (adjusted β-coefficient: 3.3).

Furthermore, women with history of gestational diabetes who later developed diabetes (n = 183) demonstrated significantly higher UACR (exponent β = 1.3) and an increased risk of elevated UACR (at least 20 mg/g; adjusted relative risk 2.3) compared with women with neither gestational diabetes nor diabetes.

The researchers noted that, following adjustment for potential confounders, gestational diabetes without subsequent diabetes was ultimately not associated with elevated UACR.

“Women who develop [gestational diabetes] in pregnancy were more likely to show increased eGFR levels at [9 to 16] years’ postpartum, which could indicate early stages of glomerular hyperfiltration and renal damage,” the researchers concluded. “However, only those who subsequently developed diabetes showed overt renal damage as evidenced by elevated UACR.”

—Christina Vogt

Reference:

Rawal S, Olsen SF, Grunnet LG, et al. Gestational diabetes mellitus and renal function: a prospective study with 9- to 16-year follow-up after pregnancy. Diabetes Care. 2018;41(5). https://doi.org/10.2337/dc17-2629

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