Pregnancy is generally not recommended for dialysis patients because it is considered a high-risk pregnancy. There are approximately 13,000 women under the age of 44 receiving chronic dialysis in the United States. Twenty-five percent of these are treated with peritoneal dialysis. A survey of 35% of women of childbearing age over a three year period revealed 9 pregnancies, or 0.25 % per year. For a reason which is not known, PD patients become less frequently pregnant than hemodialysis(CAPD, PD) patients. Peritoneal dialysis is a reasonable option for pregnant women on dialysis because it provides continuous filtration, although there may be abdominal discomfort as the baby grows. Not enough is known to recommend pregnant women on dialysis to switch from HD to PD. A PD catheter is not harmful to the baby and can be placed at any time during pregnancy. If a pregnant woman chooses PD, her doctor may decide to supplement her PD treatments with hemodialysis treatments as she gets closer to her due date to ensure that her medical status is optimized. Potential complications of PD in pregnancy include: peritonitis, bleeding, hypertension, anemia.
Fifty percent of pregnancies in CAPD patients reported to the American Registry resulted in surviving infants. The success rate for pregnancy is 43% in hemodialysis patients but the difference between the two modalities is not statistically significant. There is not enough evidence of better outcome in CAPD patients to warrant changing dialysis modalities during pregnancy. Most infants are born prematurely.
To summarize, CAPD renders a pregnancy high risk but is not in itself life threatening for the mother.
Kroly Schneider et al, Pregnancy and Successful Full-Term Delivery in a Patient on Peritoneal Dialysis: One Center’s Experience and Review of the Literature Dialysis & Transplantation, Volume 36, Issue 8, pages 438444, August 2007
Gmez Vzquez JA, MartnezCalva IE, Mendola Fernndez R, Escalera Len V, Cardona M, Noyola H.Pregnancy in end-stage renal disease patients and treatment with peritoneal dialysis: report of two cases. Perit Dial Int. 2007 May-Jun;27(3):353-8
Moumita Barua et al, Successful Pregnancies on Nocturnal Home Hemodialysis CJASN March 2008 3): (2) 392-396.
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