» Articles » PMID: 37013153

Success of Pregnancy in a Patient on High-Volume Hemodiafiltration with Citrate-Acidified Dialysate

Overview
Specialty Nephrology
Date 2023 Apr 4
PMID 37013153
Authors
Affiliations
Soon will be listed here.
Abstract

Although pregnancy in dialysis patients is rare, recent reports in the literature have shown improvement in pregnancy outcome in this population. Increasing doses of dialysis have led to improvement in fetal prognosis, but recommendations are still lacking, and there are few documented reports of pregnant woman on high-volume online hemodiafiltration. Here, we report the first successful pregnancy in a 28-year-old patient on daily high-volume online post-dilution hemodiafiltration with a citrate dialysate. At 37 weeks and 1 day, she delivered a healthy 2.3 kg baby that did not require neonatal intensive care. This case report suggests that hemodiafiltration with a dialysate acidified with citrate is safe in pregnancy. Further reports and a registry are necessary to confirm that high-volume online hemodiafiltration with a citrate dialysate should be the preferred dialysis modality in pregnant women.

References
1.
Normand G, Xu X, Panaye M, Jolivot A, Lemoine S, Guebre-Egziabher F . Pregnancy Outcomes in French Hemodialysis Patients. Am J Nephrol. 2018; 47(4):219-227. DOI: 10.1159/000488286. View

2.
Levine R, Maynard S, Qian C, Lim K, England L, Yu K . Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004; 350(7):672-83. DOI: 10.1056/NEJMoa031884. View

3.
Althaf M, Abdelsalam M, Alfurayh O . Lupus flares in two established end-stage renal disease patients with on-line hemodiafiltration during pregnancy - case series. Lupus. 2014; 23(9):945-8. DOI: 10.1177/0961203314530487. View

4.
Piccoli G, Minelli F, Versino E, Cabiddu G, Attini R, Vigotti F . Pregnancy in dialysis patients in the new millennium: a systematic review and meta-regression analysis correlating dialysis schedules and pregnancy outcomes. Nephrol Dial Transplant. 2015; 31(11):1915-1934. DOI: 10.1093/ndt/gfv395. View

5.
Akbari A, Hladunewich M, Burns K, Moretti F, Abou Arkoub R, Brown P . Circulating angiogenic factors in a pregnant woman on intensive hemodialysis: a case report. Can J Kidney Health Dis. 2016; 3:7. PMC: 4763449. DOI: 10.1186/s40697-016-0096-7. View