Dialysis helps pregnant women with kidney disease
Intensive dialysis treatments in pregnant women with kidney failure leads to a higher proportion of live births than standard dialysis care, according to a study published today in the Journal of the American Society of Nephrology (JASN).
"Frequent and longer dialysis sessions dramatically improve pregnancy outcomes, and should be considered for dialysis patients of childbearing age who want to become pregnant or who are already pregnant," says Dr. Michelle Hladunewich, Director of the Divisions of Obstetric Medicine and Nephrology at Sunnybrook Health Sciences Centre.
Pregnancy is often impossible in young women with advanced kidney disease because fertility declines as kidney disease progresses. "In the few women who are able to conceive while on dialysis, pregnancy is typically very complicated and can be dangerous for both mother and baby," says Dr. Hladunewich.
Dr. Hladunewich and her colleagues compared a group of 22 pregnant patients undergoing dialysis in Toronto with a group of 70 patients in the United States. In Toronto, young kidney failure patients were offered more intensive dialysis to help restore fertility, enabling some women to conceive. During pregnancy, the Toronto patients received on average 43 hours of dialysis per week, compared with only 17 hours per week in the United States.
The study found that for women dialyzed for more than 36 hours per week, the live birth rate was 85%. In women dialyzed for 20 hours or less per week, it was only 48%. In patients with established kidney failure at conception, the median duration of pregnancy in the more intensively dialyzed group of women from Toronto was 36 weeks, compared with 27 weeks in American women and infants were a healthier weight at birth.
"More intensive dialysis can improve pregnancy rates and dramatically improved pregnancy outcomes, while complications were few and manageable," says Dr. Hladunewich. "This study provides hope to young women on dialysis who might want to consider having a family."
Full media release
More dialysis for pregnant women with kidney failure improves outcomes for mother and baby
Toronto, ON (February 13, 2014) - Intensive dialysis treatments in pregnant women with kidney failure leads to a higher proportion of live births than standard dialysis care, according to a study published today in the Journal of the American Society of Nephrology (JASN).
"Frequent and longer dialysis sessions dramatically improve pregnancy outcomes, and should be considered for dialysis patients of childbearing age who want to become pregnant or who are already pregnant," says Dr. Michelle Hladunewich, Director of the Divisions of Obstetric Medicine and Nephrology at Sunnybrook Health Sciences Centre.
Pregnancy is often impossible in young women with advanced kidney disease because fertility declines as kidney disease progresses. "In the few women who are able to conceive while on dialysis, pregnancy is typically very complicated and can be dangerous for both mother and baby," says Dr. Hladunewich.
Dr. Hladunewich and her colleagues compared a group of 22 pregnant patients undergoing dialysis in Toronto with a group of 70 patients in the United States. In Toronto, young kidney failure patients were offered more intensive dialysis to help restore fertility, enabling some women to conceive. During pregnancy, the Toronto patients received on average 43 hours of dialysis per week, compared with only 17 hours per week in the United States.
The study found that for women dialyzed for more than 36 hours per week, the live birth rate was 85%. In women dialyzed for 20 hours or less per week, it was only 48%. In patients with established kidney failure at conception, the median duration of pregnancy in the more intensively dialyzed group of women from Toronto was 36 weeks, compared with 27 weeks in American women and infants were a healthier weight at birth.
"More intensive dialysis can improve pregnancy rates and dramatically improved pregnancy outcomes, while complications were few and manageable," says Dr. Hladunewich. "This study provides hope to young women on dialysis who might want to consider having a family."
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Media contact
Sybil Edmonds
sybil.edmonds@sunnybrook.ca
(416) 480-4040
