As kidney failure becomes more common in the United States, the number of pregnant women with kidney failure rises. More than 40% of nephrologists who were surveyed say they have cared for a pregnant woman on hemodialysis.
Hemodialysis is the blood-filtering treatment used for people with kidney failure. A person who does not have working kidneys must undergo a treatment several times a week where their blood is shunted out of their body into a machine that acts like an artificial kidney.
Of the 75 nephrologists (doctors who specialize in kidney diseases) who were surveyed, 43% said they had had a pregnant woman as a patient. Pregnant women receiving hemodialysis treatment included those who started hemodialysis during the pregnancy (32%), those who became pregnant during the first five years of hemodialysis treatment (58%) and those who became pregnant after being on dialysis for more than 5 years (10%). Severe kidney failure lowers the likelihood of a woman becoming pregnant.
Normally, a hemodialysis treatment lasts between 3 and 4 hours and must be done three times a week. Nephrologists recommend 4 to 4.5 hours of dialysis six days a week for pregnant women.
No maternal deaths were reported in the study, but 23% of the pregnancies did not result in a live birth. Half of the pregnancies were affected by pre-eclampsia, which is a condition that causes high blood pressure and which can cause serious complications for mother and fetus.
"With the increasing prevalence of kidney disease, there are now more women of child-bearing age living with kidney failure," said Dr. Kerry Willis, Chief Scientific Officer at the National Kidney Foundation. "This survey highlights that the impact of dialysis practice on maternal and fetal outcomes requires further study."
The study was presented at the National Kidney Foundation's Spring Clinical Meetings.