A Review of the Pregnant ESRD Patient

Excerpt

Pregnancy is rare in patients receiving chronic maintenance dialysis. Though ovarian function is intact in patients with end-stage renal disease, the uremic environment disrupts hypothalamic feedback, and most women on dialysis have either amenorrhea or anovulatory menstrual cycles, accounting for the low rate of pregnancy among this patient population [1]. In the United States, pregnancy among ESRD patients is estimated to occur at 0.5% per year [2]. The number of successful pregnancies in the ESRD population is even lower: in the United States, only an estimated 50% of pregnancies among chronic maintenance dialysis result in the birth of a live infant [3]. In addition, obstetric complications such as preterm delivery remain common in this population [3]. However, modifications to dialysis treatment and to management of the other complications of end-stage renal disease can be made in order to increase the chances of a successful pregnancy in this population of patients. …