Pregnancy or Uremia? – Case Report and Review of Conception, Pregnancy, and Complications in Peritoneal Dialysis Patients

Sandhu, A.; Regmi, Anil; Buchwald, David; Tzamaloukas, Antonios H.

doi:10.7759/cureus.206

Cited by 3 publications

(15 citation statements)

References 20 publications

(24 reference statements)

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“…Although LH levels in women on dialysis are elevated, they fail to have luteal surge of LH, which is directly related to ovulation [7,8]. Many other fertility-affecting factors in ESRD patients include subclinical hypothyroidism, medications, fatigue, anemia, and depression, which further results in lack of libido [9][10][11].…”

Section: Conceptionmentioning

confidence: 99%

“…Beta-hCG and maternal serum pregnancy-associated plasma protein A (PAPP-A) are generally elevated in ESRD patients because these are inversely correlated with creatinine clearance. Hence, careful interpretation of these tests is advised while screening these women in the first trimester [11,13,14].…”

Section: Diagnosismentioning

confidence: 99%

“…Regular PD prescription was resumed 12 h after delivery. She was discharged to home 3 days after delivery [11].…”

Section: Some Special Problems In Peritoneal Dialysismentioning

confidence: 99%

“…Approximately, 80% of pregnant dialysis women have a blood pressure (BP) higher than 140/90 and even more than 50% have BP greater than 170/110. Given continuous therapy in PD to achieve euvolemic status, it is thought that PD patient should have lower risk of hypertension, but small studies have shown no difference [11,12]. Since hypertension in dialysis patients is mostly related to their volume status, it poses another challenge to determine dry weight in pregnant dialysis women (see below for details).…”

Section: Hypertensionmentioning

confidence: 99%

“…Preeclampsia is difficult to diagnose in dialysis patients due to anuria that makes unable to determine proteinuria. In these patients, preeclampsia diagnosis relies on the assessment of worsening blood pressure, fetal growth retardation, alterations in placental Doppler blood flow and hematological abnormalities in case of HELLP syndrome [11,15].…”

Section: Preeclampsia/eclampsia/hellp Syndromementioning

confidence: 99%

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Peritoneal Dialysis and Pregnancy

Sandhu¹

2016

Some Special Problems in Peritoneal Dialysis

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Pregnancy is infrequent and has complicated course in women undergoing renal replacement therapy. According to recent data, rates of conception in women on hemodialysis increased from 1.5% to 15% and 1.1% in women on peritoneal dialysis (PD). Lower rates in patients on peritoneal dialysis are due to mechanical factors on top of functional and physiological irregularities. Due to assumption of almost negligible rates of conception, pregnancy symptoms in patients with chronic kidney disease stage V can be confused with uremic symptoms. Once pregnancy is established, multilevel changes need to be made in this patient population. The coordinated care between a nephrologist, obstetrician, and nutritionist is essential for better outcomes. In this chapter, we review a near-missed but a successful case report and details of pregnancy, outcomes, and complications in women on peritoneal dialysis.

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Section: Conceptionmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

“…Regular PD prescription was resumed 12 h after delivery. She was discharged to home 3 days after delivery [11].…”

Section: Some Special Problems In Peritoneal Dialysismentioning

confidence: 99%

Section: Hypertensionmentioning

confidence: 99%

Section: Preeclampsia/eclampsia/hellp Syndromementioning

confidence: 99%

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Peritoneal Dialysis and Pregnancy

Sandhu¹

2016

Some Special Problems in Peritoneal Dialysis

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Nutritional Recommendations for Pregnant Women Receiving Dialysis: A Scoping Review

Cutajar,

Lambert

2024

Kidney and Dialysis

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Pregnancy in the dialysing population is an infrequent but increasing event. There is a lack of contemporary guidance regarding the nutritional management of this complex patient group. The aim of this scoping review was to identify, evaluate and summarise the evidence base describing nutritional recommendations for pregnant women receiving dialysis. A systematic search strategy of four databases and the grey literature was conducted. Eligible publications contained reference to recommendations regarding nutrition, supplements, breastfeeding, dietary patterns, and/or weight recommendations for pregnant dialysing women. A total of 136 eligible records were included for synthesis including 66 case reports/case series, 46 reviews, 15 book chapters, 5 editorials, and 4 consensus guidelines/position papers. Recommendations regarding energy, protein, dietary patterns, weight, and vitamin and mineral supplementation were common. However, significant discrepancy across these recommendations was evident. There were limited recommendations regarding other nutrients and breastfeeding. A summary of nutritional recommendations to guide clinical practice was constructed. Pregnancy planning, pre-conception dietetic counselling, interprofessional education, and the guidance synthesised in this review could be utilised by clinicians to improve clinical management and optimise outcomes in these patients. Future research should explore the experiences and perspectives of pregnant dialysing women, investigate nutrient losses during intensive dialysis, and evaluate postpartum follow-up.

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Some Special Problems in Peritoneal Dialysis

Ekart¹

2016

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He is an active member of ERA-EDTA; a member of ERA-EDTA Scientific Working Groups EURECA-m, DIABESITY, and EUDIAL; board member of the European Journal of Internal Medicine; and reviewer for many international journals (KI, CJASN, AJKD, NDT, AJN, AJH, CKJ, EJIM). His primary research interest is clinical problems in chronic kidney disease and dialysis patients, with emphasis on cardiovascular complications in these patients. Professor Ekart has published more than 50 papers (PubMed).

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Pregnancy or Uremia? – Case Report and Review of Conception, Pregnancy, and Complications in Peritoneal Dialysis Patients

Cited by 3 publications

References 20 publications

Peritoneal Dialysis and Pregnancy

Peritoneal Dialysis and Pregnancy

Nutritional Recommendations for Pregnant Women Receiving Dialysis: A Scoping Review

Some Special Problems in Peritoneal Dialysis

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