Association of Gestational Diabetes and CKD by Race/Ethnicity

Boston—Diabetes is a leading cause of chronic kidney disease (CKD). Women who develop gestational diabetes are at increased risk for diabetes and thus for CKD. Non-white women are at increased risk for diabetes, albuminuria, and progression of CKD compared with non-Hispanic white women. Joanne Rodrigue, MPH, and colleagues conducted an analysis to examine the link between gestational diabetes and CKD based on race/ethnicity. Results were reported during a poster session at the NKF Spring Clinical Meetings in a poster titled Gestational Diabetes, Ethnicity, and Development of CKD.

CKD was defined as estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m² with an albumin-to-creatinine ratio ≥30 mg/g or eGFR 15 to 59 mL/min/1.73 m². Gestational diabetes was retrospectively recorded as a yes/no response (no response excluded) to the survey question, “During pregnancy, have you even been told you have diabetes, sugar diabetes, or gestational diabetes?”

Survey weighted multivariable logistic regression models were adjusted for age at baseline (age at time of gestational diabetes diagnosis or age at last live birth for those without gestational diabetes), time (age at survey minus baseline), ethnicity, and education. Following significant interaction (<.001), ethnicity was further stratified (non-Hispanic white women vs Hispanic women) to assess whether diabetes mellitus following pregnancy modified the association between gestational diabetes and CKD.

Of the respondents to the survey, 162 had gestational diabetes. There was no association between gestational diabetes and CKD. However, Hispanic women with gestational diabetes had increased odds of CKD (odds ratio, 2.12; 95% confidence interval, 1.19-3.78); there was no increase in the odds of CKD among non-Hispanic white women who had gestational diabetes.

“These results suggest that Hispanic women who experience gestational diabetes have a higher likelihood of developing CKD; this may be explained by subsequent diabetes mellitus after pregnancy,” the researchers said.

Source: Rodrigue J, Baneriee T, McCulloch C, et al. Gestational diabetes, ethnicity, and development of CKD. Abstract of a poster presented at the National Kidney Foundation 2019 Spring Clinical Meetings, May 8-12, 2019, Boston, Massachusetts.