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Dialysis in Pregnancy: An Update Review
Sidar Copur1, Metehan Berkkan1, Carlo Basile2
1Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
Blood Purification
|June 28, 2023
Summary
Pregnancy in end-stage kidney disease (ESKD) patients on dialysis is rare but carries risks. This review details management strategies and outcomes for pregnant dialysis patients, highlighting the need for future research and guidelines.
Area of Science:
- Nephrology
- Obstetrics
- Public Health
Background:
- Chronic kidney disease and end-stage kidney disease (ESKD) represent significant public health challenges.
- Pregnancy is uncommon in ESKD patients due to reduced fertility, and carries elevated risks for both mother and fetus.
Purpose of the Study:
- To review the effects and management of dialysis during pregnancy in ESKD patients.
- To provide recommendations for optimizing care and identify gaps in current knowledge.
Main Methods:
- Literature review focusing on pregnancy outcomes in dialysis patients.
- Discussion of management strategies including dialysis parameters and modality selection.
- Analysis of risks associated with acute kidney injury during pregnancy.
Main Results:
- While live births have increased in pregnant dialysis patients, adverse events remain a concern.
- Specific management recommendations are proposed for blood urea nitrogen levels, dialysis frequency/duration, and modality choice.
- Peritoneal dialysis presents challenges in the third trimester.
Conclusions:
- There is a lack of consensus guidelines for managing pregnant dialysis patients.
- Optimizing pre-pregnancy health and tailoring dialysis regimens are crucial.
- Further large-scale studies are needed to establish evidence-based guidelines.
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