Pregnancy in Patients Receiving Home Dialysis

Clin J Am Soc Nephrol. 2024 Jan 29. doi: 10.2215/CJN.0000000000000437. Online ahead of print.ABSTRACTPregnancy is an important goal for many women with chronic kidney disease (CKD) or kidney failure, but important barriers exist, particularly as CKD stage progresses. Women with advanced CKD often have a limited fertility window and may miss their opportunity for a pregnancy if advised to defer until after kidney transplantation. Pregnancy rates in women with advanced kidney failure or receiving dialysis remain low, and despite the improved outcomes in recent years, these pregnancies remain high risk for both mother and baby with high rates of preterm birth due to both maternal and fetal complications. However, with increased experience and advances in models of care, this paradigm may be changing. Intensive hemodialysis regimens have been shown to improve both fertility and live-birth rates. Increasing dialysis intensity and individualizing dialysis prescription to residual renal function, to achieve highly efficient clearances, has resulted in improved live birth rates, longer gestations and higher birth weights. Intensive hemodialysis regimens, particularly nocturnal and home-based dialysis, are therefore, a potential option for women with kidney failure desiring pregnancy. Global initiatives for the promotion and uptake of home-based dialysis are gaining momentum and may have advantages in this unique patient population. In this article we review the epidemiology and outco...
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Source Type: research