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Pregnancy tests with end-stage renal disease
Brenda G Fahy1, Valerie A Gouzd, Joseph N Atallah
1Department of Anesthesiology, University of Kentucky, Lexington, KY 40536, USA.
Journal of Clinical Anesthesia
|December 23, 2008
Summary
A pregnancy test may show positive results in women with end-stage renal disease (ESRD) due to elevated beta-human chorionic gonadotropin (beta-HCG) levels, even without pregnancy. This highlights the importance of further investigation beyond initial screening in specific patient populations.
Area of Science:
- Nephrology
- Reproductive Endocrinology
- Clinical Chemistry
Background:
- Pregnancy testing is standard in preoperative evaluations for women of childbearing age, particularly with uncertain menstrual history or suspected pregnancy.
- End-stage renal disease (ESRD) can affect hormonal levels, potentially complicating diagnostic interpretations.
Observation:
- A woman of childbearing age with ESRD presented with irregular menstruation and unprotected sexual activity, prompting a preoperative serum pregnancy test.
- The beta-human chorionic gonadotropin (beta-HCG) level was elevated, initially suggesting pregnancy.
Findings:
- Further diagnostic work-up revealed that the elevated beta-HCG levels were a result of ESRD, not an actual pregnancy.
- This case demonstrates a potential false-positive pregnancy test scenario in patients with significant renal impairment.
Implications:
- Clinicians should consider ESRD as a potential cause for elevated beta-HCG levels in women of childbearing age, necessitating comprehensive evaluation.
- This finding underscores the importance of integrating patient-specific conditions, such as ESRD, into the interpretation of hormonal assays to avoid misdiagnosis.
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