To analyze the influencing factors of long-term renal prognosis in patients with preeclampsia PE.

A retrospective cohort analysis was conducted on patients diagnosed with PE who were admitted to the general obstetrics ward of Xuanwu Hospital of Capital Medical University from January 2009 to February 2021 (excluding those with baseline comorbidity as chronic kidney disease). The follow-up was completed until November 2021. The patients′ data were collected including demographic information, general information, and laboratory examination indicators. Based on their blood pressure at the end of follow-up, the patients were divided into a residual hypertension group and a normotensive group. And based on their urinary protein status at the end of follow-up, the patients were divided into a residual proteinuria group and a negative urinary protein group. The Kaplan-Meier curve and Cox regression model were employed to analyze the influencing factors of long-term residual hypertension and long-term residual proteinuria in the patients with PE.

A total of 604 patients with PE completed the follow-up, including 251 patients with non-severe PE and 353 patients with severe PE. The median follow-up duration was 8.19 years. At the end of follow-up, 65 patients (10.8%) had residual hypertension, and 29 patients (4.8%) had residual proteinuria. Compared with the normotensive group, the residual hypertension group had a significantly shorter gestational age at the onset of PE, but significantly higher age, baseline systolic blood pressure, and hemoglobin at the end of follow-up (P<0.05). Multivariate COX regression analysis showed that body mass index ≥30 kg/m² (HR=2.57, 95%CI: 1.36-4.85, P=0.004), baseline systolic blood pressure ≥160 mmHg (HR=2.80, 95%CI: 1.55-5.07, P=0.001), baseline hemoglobin ≥120 g/L (HR=2.07, 95%CI: 1.17-3.67, P=0.012), and baseline serum albumin <30 g/L (HR=2.23, 95%CI: 1.18-4.21, P=0.013) were independent influencing factors of the long-term residual hypertension in the patients with PE. At the end of follow-up, the body mass index and baseline systolic blood pressure of the residual proteinuria group were significantly higher than those of the negative urinary protein group. Multivariate COX regression analysis showed that the baseline systolic blood pressure≥160 mmHg(HR=2.70, 95%CI: 1.14-6.38, P=0.024)was an independent influencing factor for the residual proteinuria.

Residual hypertension occurred in 10.8% of the PE patients, and residual proteinuria in 4.8% of the PE patients. Obesity before childbirth, higher hemoglobin, and hypoproteinemia were independently associated with the residual hypertension of the patients. Higher systolic blood pressure was an independent influencing factor for both residual hypertension and residual proteinuria in the patients with PE.