Peritoneal Dialysis Initiation to treat end stage kidney desease during pregnancy. A report of 2 cases.

Abstract

Despite strong evidence suggesting that peritoneal dialysis (PD) is a comparable technique to long-hour hemodialysis (HD) for pregnant patients (11,12), few cases are described in the current literature. Moreover, initiating PD in a pregnant woman needing extrarenal epuration is rarely described if at all.
 In this article, we present two cases of patients who initiated PD while being already multiple month pregnant: the first one 14 years ago and the other today.
 Our two patients are in their thirties, are respectively 16 and 10 weeks pregnant and have a history of anti-phospholipids syndrome. It was decided to start a PD program with both of them. Our first patient gave birth to a healthy 2.5 kg and 45 cm daughter despite an episode of peritonitis and the freeing of the peritoneal catheter from adherences. Our second patient is currently on dialysis without complications and is now 28 weeks pregnant with a healthy monitored child.
 Initiating PD in a pregnant patient is a subject that has not yet been published in the current scientific literature. With higher pregnancy rates than ever in the end stage renal disease population (31), we suggest to assess the objective benefits of PD extrarenal epuration method by performing a prospective comparative study between PD and HD.

Successful pregnancy in peritoneal dialysis: a case report

“…Les études concernant la prise en charge de la grossesse en DP sont moins nombreuses qu'en hémodialyse (HD) [5][6] [7], probablement en raison de la faible diffusion de cette technique dans la population générale par rapport à l'HD, et de sa courte demi-vie (5 ans en moyenne) compte tenu du passage rapide des patientes vers la transplantation rénale. Bien que le taux de grossesse chez les femmes en DP soit plus faible que chez les femmes en HD (1,1% en DP contre 2,4% en HD) [1], les chances de succès sont meilleures [8].…”