Ignorance is Not Bliss: The Case for Comprehensive Reproductive Counseling for Women with Chronic Kidney Disease

Abstract

The bioethics literature has paid little attention to matters of informed reproductive decision-making among women of childbearing age who have chronic kidney disease (CKD), including women who are on dialysis or women who have had a kidney transplant. Women with CKD receive inconsistent and, sometimes, inadequate reproductive counseling, particularly with respect to information about pursuing pregnancy. We identify four factors that might contribute to inadequate and inconsistent reproductive counseling. We argue that women with CKD should receive comprehensive reproductive counseling, including information about the possibility of pursuing pregnancy, and that more rigorous research on pregnancy in women with CKD, including women on dialysis or who have received a kidney transplant, is warranted to improve informed reproductive decision making in this population. KeywordsChronic kidney disease • Dialysis • End stage renal disease • Kidney transplantation • Pregnancy • Reproduction • Reproductive counseling • Shared decision making Women of childbearing age who have chronic kidney disease (CKD), including women who are on dialysis or women who have had a kidney transplant, receive inconsistent and, sometimes, inadequate reproductive counseling, particularly with