With the rise in chronic kidney disease in the United States, pregnancy in women with kidney failure is becoming more common, according to new findings presented at the National Kidney Foundation’s 2015 Spring Clinical Meetings.
Severe kidney disease can make it hard to become pregnant, but among 75 U.S.-based nephrologists surveyed, 43% reported having cared for pregnant women on dialysis, Drs. Mala Sachdeva, Jyotsana Thakkar, and Ilene Miller of the Hofstra North Shore – LIJ School of Medicine found.
“Before this survey, it had been more than 15 years since data had been collected on pregnancy outcomes for women on hemodialysis in the United States,” said Sachdeva. “We wanted to provide an update by evaluating the current U.S. experience including overall practice patterns and certain maternal and fetal outcomes that have occurred with this specific patient population.”
According to this national survey, pregnant women receiving hemodialysis treatment ranged from those who initiated dialysis during the pregnancy (32%), those who became pregnant during the first five years of treatment (58%) and those who became pregnant after being on dialysis for 5+ years (10%).
Most nephrologists prescribed dialysis 4-4.5 hours a day for six days per week. The survey revealed no maternal deaths, but 23% of pregnancies did not result in live births and 50% were complicated by preeclampsia, a condition marked by high blood pressure that may lead to poorer maternal and fetal outcomes.
“With the increasing prevalence of kidney disease, there are now more women of child-bearing age living with kidney failure,” said Dr. Kerry Willis, Chief Scientific Officer at the National Kidney Foundation. “This survey highlights that the impact of dialysis practice on maternal and fetal outcomes requires further study. This topic was considered in the latest update of the NKF-KDOQI Clinical Practice Guideline for Hemodialysis Adequacy, to be published later this year.”