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Gestational diabetes may be risk factor for chronic kidney disease

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Gestational diabetes may predispose women to early-stage kidney damage, a precursor to chronic kidney disease, according to US researchers.

As a result, they suggested that women who have had gestational diabetes may benefit from periodic check-ups to detect early-stage kidney damage and receive treatment.

“Women who have had gestational diabetes may benefit from periodic check-ups”

Cuilin Zhang

Other forms of diabetes that occur outside of pregnancy are known to increase the risk for chronic kidney disease, in which the kidneys have difficulty filtering wastes from the blood.

However, few previous studies have investigated the potential link between gestational diabetes and chronic kidney disease, noted the researchers in the journal Diabetes Care.

They found that women who had gestational diabetes were more likely to have a high glomerular filtration rate (GFR), an estimate of how much blood per minute passes through kidney filters.

They noted that a very high GFR was thought to precede the early kidney damage that accompanies “pre-diabetes” – blood glucose levels that are higher than normal but not enough to be classified as diabetes.

Researchers collected blood and urine samples and analysed data from Danish women who had pregnancies from 1996 to 2002.

“Women who develop GDM in pregnancy were more likely to show increased eGFR levels at nine to 16 years’ postpartum”

Study authors

The data included results from tests for diabetes and kidney functioning an average of 13 years later. Of this group, 601 women had gestational diabetes and 613 did not.

Women who had gestational diabetes and later developed diabetes were around nine times more likely to have an elevated GFR later in life, compared to those who did not have gestational diabetes.

Women who only had gestational diabetes had more than triple the risk of an elevated GFR, noted the researchers.

They said the results for the latter group remained consistent even after they controlled for other factors, such as obesity, blood pressure disorders of pregnancy and the use of certain medications.

“Women who develop GDM in pregnancy were more likely to show increased eGFR levels at nine to 16 years’ postpartum, which could indicate early stages of glomerular hyperfiltration and renal damage,” they said.

However, the researchers noted that only those who subsequently developed diabetes showed overt renal damage as evidenced by elevated urinary albumin to creatinine ratio.

The researchers noted that their study could not prove that gestational diabetes caused kidney damage and highlighted that further investigation was needed to confirm their findings.

Senior study author Dr Cuilin Zhang said: “Our findings suggest that women who have had gestational diabetes may benefit from periodic check-ups to detect early-stage kidney damage and receive subsequent treatment.”

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