Successful Pregnancy in a Patient with Polycystic Kidney Disease and Advanced Renal Failure without Prophylactic Dialysis

Hassan, Kamal; Weissmam, I.; Osman, Salwa; Gery, R.; Oettinger, Moshe; Shasha, Shaul M.; Kristal, Batya

doi:10.1159/000045889

Cited by 3 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among morphologic alterations, we verified pregnancy in a patient with polycystic kidney disease. Hassan [17] observed a pregnant women with polycystic kidney disease and verified that it was not necessary to make use of prophylactic dialysis and there was no acceleration in the renal function deterioration. The newborn was delivered successfully and presented normal weight.…”

Section: Discussionmentioning

confidence: 93%

Pregnancy in Patients with Chronic Renal Insufficiency at Hospital de Clínicas of Porto Alegre, Brazil

Trevisan¹,

Ramos²,

Martins‐Costa³

et al. 2004

Renal Failure

View full text Add to dashboard Cite

Chronic renal insufficiency (CRI) decreases reproductive capability. The biggest challenge in monitoring pregnant women with renal disease is to keep the intrauterine environment favorable to the fetus. One of the common prognosis in this kind of pregnancy involves premature birth, restricted growth and mental retardation. Also, the risk of developing complications is higher for the mother. This study focuses on evaluating CRI patients' clinical conditions during pregnancy, checking fetal development and birth and verifying the prevalence of CRI in pregnant women attended at Hospital de Clínicas of Porto Alegre-Brazil (HCPA). This is a retrospective study with both a control and an case group of pregnant women with CRI who delivered their babies at HCPA from 1989 to 1999. The case group is composed of pregnant women with CRI, while the control group was paired according to maternal and gestational ages and to the time of the delivery, which should be the same both in the experimental and in the control group. Among the criteria usually used to identify CRI, we chose the creatinine level higher than 1.5 mg/dL. Significance was established in 0.05%. Our results demonstrate that the prevalence of CRI was 6/10,000 births. Average maternal age was 28. Sixty five per cent of the patients, in both the groups, underwent prenatal monitoring, 40% presented preeclampsia, 48% presented urinary infection. Among the CRI complications, 48% of the cases presented anemia and 56% presented systemic hypertension. Average hematocrit was 24% while hemoglobin was 6.7 g/dL, which leads us to the conclusion that patients presented anemia during pregnancy. Average creatinine was 4.61 mg/dL. It is relevant that 64% of the CRI cases migrated to a substitutive renal therapy method. As for the fetus evolution in the case group, we confirmed the findings of previous studies, such as larger number of premature births (newborns younger than 36 weeks in 60% of the cases), larger number of cesarean section (56%), lower weight at birth (1980 gr. in average), lower APGAR scores in the first and fifth minute (4.13 and 5.08, respectively) in comparison to the control group (7.52 and 8.63, respectively). We can state that babies born from CRI patients present underdevelopment. Also, mothers with CRI develop more complications during pregnancy.

show abstract

Section: Discussionmentioning

confidence: 93%

Pregnancy in Patients with Chronic Renal Insufficiency at Hospital de Clínicas of Porto Alegre, Brazil

Trevisan¹,

Ramos²,

Martins‐Costa³

et al. 2004

Renal Failure

View full text Add to dashboard Cite

show abstract

“…The patient in this case would be classified into Group C, which refers to patients in renal failure secondary to advanced PKD. Katz et al (6) first described a successful pregnancy in a patient with Group C disease, and other cases have also been reported (6-9). However, few of them underwent HD during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Successful Pregnancy in a Patient with Autosomal Dominant Polycystic Kidney Disease on Long-Term Hemodialysis

et al. 2014

View full text Add to dashboard Cite

Recent advances in dialysis and a multidisciplinary approach to pregnant patients with advanced chronic kidney disease provide a better outcome. A 38-yr-old female with autosomal dominant polycystic kidney disease (ADPKD) became pregnant. She was undergoing hemodialysis (HD) and her kidneys were massively enlarged, posing a risk of intrauterine fetal growth restriction. By means of intensive HD and optimal management of anemia, pregnancy was successfully maintained until vaginal delivery at 34.5 weeks of gestation. We discuss the special considerations involved in managing our patient with regard to the underlying ADPKD and its influence on pregnancy.Graphical Abstract

show abstract

“…First, there have been a number of case reports of women with CKD who had successful pregnancies following intensive dialysis designed to suppress the BUN level to the 30–50 mg/dl range (12–14). However, there are also a few cases of women with average BUN levels well above 50 mg/dl who had successful pregnancies with (15) and without (16,17) dialysis.…”

Section: Dialysis In Women With Ckdmentioning

confidence: 99%

Dialysis in Pregnant Women with Chronic Kidney Disease

Shemin

2003

Seminars in Dialysis

View full text Add to dashboard Cite

Pregnancy occurs uncommonly in women with chronic kidney disease (CKD) and fetal outcome tends to be poor, with high rates of prematurity and mortality. Dialysis, by complementing residual renal function, may improve fetal outcome in pregnant women with CKD. Although there are no prospective or randomized trials that examine the relationship between dialysis and fetal outcome, there is evidence that increased solute clearance, by early initiation of or intensification of dialysis, is beneficial for the health of the fetus. Case reports and observational studies from the United States, Belgium, and Saudi Arabia suggest that there is a relationship between successful pregnancy and the amount of dialysis received. Unfortunately, in these reports, measures of residual renal function and dialysis adequacy are lacking or incomplete. Nonetheless, compared to nonpregnant patients with CKD, in pregnant women with CKD it is reasonable to begin dialysis at a higher level of residual renal function in the hope of improving fetal outcome.

show abstract

Successful Pregnancy in a Patient with Polycystic Kidney Disease and Advanced Renal Failure without Prophylactic Dialysis

Cited by 3 publications

References 14 publications

Pregnancy in Patients with Chronic Renal Insufficiency at Hospital de Clínicas of Porto Alegre, Brazil

Pregnancy in Patients with Chronic Renal Insufficiency at Hospital de Clínicas of Porto Alegre, Brazil

Successful Pregnancy in a Patient with Autosomal Dominant Polycystic Kidney Disease on Long-Term Hemodialysis

Dialysis in Pregnant Women with Chronic Kidney Disease

Contact Info

Product

Resources

About