Successful pregnancy in a patient with high volume pre-dilution on-line haemodiafiltration. Is it the best dialysis option in women with chronic kidney disease?

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

“…In 2020, Puddu and colleagues described 2 pregnant women on high-volume HDF whose pregnancies went to term and who gave birth to healthy infants [8] . In the same year, Crucelegui et al [9] described a 32-year-old hemodialysis-dependent woman on pre-dilutional HDF who had a successful pregnancy and delivered a healthy new-born baby.…”

“…Dialysis dose appears to be the cornerstone of these improved results. Four case reports have described favorable outcomes in pregnant patients on hemodiafiltration (HDF) [6][7][8][9]. In all but 1 patient, who presented with metrorrhagia and a small placental hematoma, there were no complications from the use of bicarbonate dialysate acidified with citrate in predilutional HDF [8].…”

Hemodiafiltración de alto volumen en situaciones especiales: embarazo

“…Ya en pacientes en tratamiento sustitutivo renal de forma crónica se comienzan a reportar casos recientemente y en pacientes aislados. En 2020 se describe el primer caso de una mujer embarazada en tratamiento crónico con HVHDF de alto volumen a la que hay que cambiarle la modalidad a predilucional por presencia de un hematoma placentario, realizándole el tratamiento seis veces por semana, 5 horas por sesión, con volúmenes convectivos ajustados aceptables, niveles de urea sérica prediálisis < 50 mg/dl y Kt/V semanal entre 12 y 14 7 , como se observa en la figura 1.…”