Monthly Archives: May 2022

pregnancy on dialysis

Is Pregnancy On Dialysis Possible?

The frequency of pregnancies in women on dialysis is extremely low, although the percentage of successful pregnancies has increased over the years, being, according to different series, higher than 70%. These pregnancies are not without complications for both the mother and the fetus, the management of which requires the joint work of the nephrologist in Delhi, the gynecologist, the nurse and the nutritionist.

Increased dialysis time is known to prolong gestation, resulting in children with higher birth weight, improved life chances, and decreased long-term complications.

The total dialysis time that should be administered weekly varies in the different studies, but, regardless of the criteria that are followed, the prescription of hemodialysis must be sufficient to maintain stable maternal conditions in relation to blood volume, blood pressure and blood pressure gain, weight between sessions.

Nocturnal hemodialysis would have the following advantages: it would allow greater clearance of small and medium molecular weight molecules, and it would improve the control of metabolic, electrolytic, phosphorous, volemia, and blood pressure profiles.

Experience with peritoneal dialysis in pregnant women is limited to a very small number of patients; in fact, the incidence of pregnancy in these patients is lower than those on hemodialysis. This could be due to the presence of hypertonic solutions in the peritoneum, to previous episodes of peritonitis or to physical factors that would interfere with fetal implantation. Most authors recommend not to change the dialysis modality after conception.

The measures referred to in the different publications to achieve successful pregnancies in these patients include: the multidisciplinary approach, increasing dialysis time, keeping pre-dialysis urea levels low, trying to prevent prematurity, strictly controlling blood pressure and electrolytes, preventing urinary infections and adequate fetal monitoring.

Kidney Disease In Pregnancy

The Kidney And Kidney Disease In Pregnancy

Pregnancy is a very special period in the life of a couple and in particular, a woman, but it may seem like a difficult dream to achieve in kidney patients.


In women without kidney disease, the urinary system undergoes anatomical and functional changes to adapt to the new state: blood flow to the kidney increases up to 60%, which causes creatinine to drop slightly and proteinuria to rise (parameters that usually serve to evaluate renal function). It also increases the amount of water in the body which leads to a dilution of hemoglobin (anemia of pregnancy that is physiological) and blood pressure drops slightly. These normal changes may not happen in women with kidney disease.


Kidney patients have a harder time getting pregnant. When it happens, the pregnancy itself may be subject to more complications than in a healthy woman, which always means a risky pregnancy and implies a closer follow-up by the obstetrician and the nephrologist. Usually, kidney disease does not worsen during pregnancy, but it can get significantly worse after delivery. The baby also requires special monitoring. The cause of kidney disease and the stage (severity) of it also determine the evolution of pregnancy.


Pregnancy in women on dialysis is rare.

There are reports of pregnancies occurring on peritoneal dialysis, but the increase in abdominal volume due to pregnancy makes exchanges on peritoneal dialysis difficult, so if a woman on peritoneal dialysis becomes pregnant, she should consider switching to hemodialysis (albeit temporarily, during gestation).

When women on hemodialysis become pregnant, they see the treatment changed. Among other technical changes, they must undergo dialysis daily (five to six sessions/week) so that the toxics do not accumulate and suffer as little variation as possible so as not to affect the baby.

In both peritoneal dialysis and hemodialysis, the risk of miscarriage is greater than in a patient who does not undergo dialysis, and as such, the follow-up must be done by the obstetrician and the best nephrologist in Delhi on a regular and careful basis.


In kidney transplant women, fertility is partially restored, making it easier to get pregnant. These pregnancies must be planned and monitored, as they are still risky pregnancies. One of the main precautions is the choice of immunosuppression. Some drugs can affect the baby, so the medication schedule may have to be changed. In this context, there may be a higher risk of rejection of the transplanted kidney. With regard to childbirth, this should preferably be done vaginally so that there is no risk of injuring the transplanted kidney during a cesarean section.


If a woman donates a kidney to a kidney patient, her fertility is not affected and pregnancy does not involve greater risks than if she had both kidneys.