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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Dialysis in pregnancy.

Kate Wiles1, Leandro de Oliveira2

  • 1Department of Women and Children's Health, King's College London and the Biomedical Research Centre, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom.

Best Practice & Research. Clinical Obstetrics & Gynaecology
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Summary

Pregnancies in women with kidney disease on dialysis are high-risk but improving. Careful management and pre-pregnancy counseling are crucial for better outcomes in women with end-stage renal disease.

Keywords:
Peritoneal dialysisPregnancyRenal dialysisRenal replacement therapyReproduction

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Area of Science:

  • Nephrology
  • Obstetrics
  • Reproductive Medicine

Background:

  • Kidney disease significantly affects female fertility.
  • Despite challenges, pregnancies in women on dialysis are increasingly reported.
  • End-stage renal disease (ESRD) presents unique risks during pregnancy.

Purpose of the Study:

  • To review the prevalence of dialysis and pregnancy in women of childbearing age.
  • To summarize pregnancy outcomes for women undergoing dialysis.
  • To provide guidance on pre-pregnancy counseling and management of pregnancy on dialysis.

Main Methods:

  • Literature review on dialysis, pregnancy, and fertility in women with ESRD.
  • Summary of pregnancy outcomes associated with dialysis intensity.
  • Examination of factors influencing the decision to initiate dialysis during pregnancy.

Main Results:

  • Pregnancies on dialysis, while increasingly successful, remain high-risk.
  • Adverse outcomes include pregnancy loss, pre-eclampsia, preterm delivery, and low birth weight.
  • Dialysis intensity is associated with pregnancy outcomes.

Conclusions:

  • Pre-pregnancy counseling and careful management are essential for pregnant women on dialysis.
  • Peritoneal dialysis presents specific advantages and disadvantages during pregnancy.
  • Optimizing dialysis and supportive care can improve maternal and neonatal outcomes.