Management of the Pregnant Dialysis Patient

In this report, the outcome, diagnosis, management, and complications of pregnancy in dialysis patients are discussed. The advantages and disadvantages to the use of peritoneal dialysis and hemodialysis and the changes in dialysis regimen used in pregnant women are addressed. Maternal complications, particularly hypertension and anemia, are reviewed. This report looks at the approach to the management of anemia and calcium/phosphorus metabolism in the setting of limited information. The report also discusses pregnancy outcome for the mother and fetus, including the problem of prematurity and fetal loss. Special considerations in women with lupus and diabetes are noted. Pregnancy in dialysis patients remains a high-risk undertaking for both the patient and the infant. There are large gaps in our knowledge base regarding the effect of the abnormalities associated with renal failure on pregnancy. The survival of the infant and the safety of the mother depend on close cooperation among all the specialities involved, including nurses, doctors, nutritionists, and social workers from nephrology, perinatology, and neonatology.