Preeclampsia (PE) is characterized by persistently high blood pressure (BP) that worsens during pregnancy or the postpartum period. It is frequently accompanied by other symptoms such as proteinuria, high BP, or indications of kidney or other organ damage [1]). PE affects between 3–5 % of pregnancies [2]. Although the risk factors for PE are not well understood, they often include comorbidities like preexisting diabetes [[3], [4]], hypertension (HTN) [5], obesity [6], and chronic kidney disease (CKD) [[7], [8]]. Conversely, PE has been shown to precede and increase the risk for several comorbid conditions such as HTN [9], vascular diseases [10], and end stage renal disease (ESRD) later in life [11].

CKD occurs in 14 % of US adults with even higher prevalences in black, diabetic, or low-income populations [12]. Additionally, very high prevalences of HTN (84 %) are seen in patients with CKD [13]. PE has been reported to occur up to 40 % of pregnancies in women with pre-existing CKD [14]. However, studies are limited in the diagnostic criteria for PE in mothers with pre-existing HTN and CKD. It is also unclear if this is a mechanistic driver of PE or just an association with commonly seen CKD comorbidities such as obesity, diabetes, and HTN. Most epidemiological studies of PE do not take race into account, or their populations have significantly underrepresented minority mothers. Indeed, black or African American mothers have higher risks of gestational abnormalities including PE as compared to white counterparts (OR 1.6) [15]. Whether this disparity is due to increased prevalence of CKD has not been thoroughly tested. Therefore, we retrospectively investigated the impact of race on the development of PE in women with CKD in electronic health records from a Mississippi hospital.