Document Detail


Successful pregnancy with nocturnal hemodialysis.
MedLine Citation:
PMID:  15492959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 31-year-old woman with end-stage renal disease was referred to the Toronto General Hospital (Ontario, Canada) for conversion from conventional hemodialysis (CHD; 4 h/session, 3 sessions/wk) to nocturnal hemodialysis (NHD; 7 h/session, 5 to 6 treatments/wk) because of refractory hypertension. As expected, blood pressure control was superior with NHD therapy, and her requirement of vasoactive medications also decreased. To our surprise, 8 months after conversion to NHD therapy, she regained normal menstrual cycles. Two years after NHD therapy initiation, the patient became pregnant, at which time her dialysis prescription was changed to 7.5 h/session, 7 nights/wk. During her pregnancy, blood pressure was well controlled, and biochemical, hematologic, and metabolic parameters were targeted to physiological levels. The patient had an uncomplicated vaginal delivery of a healthy 3,025-g infant at 38 weeks' gestation. This case shows that on NHD therapy, our patient was able to resume ovulation and have an uncomplicated pregnancy. We speculate that augmentation of uremic clearance by means of NHD was pivotal in maintaining a normal nonproblematic pregnancy. Future studies are required to further understand the impact of intensive hemodialysis therapy on reproductive endocrine functions and determine the best management of such patients during pregnancy.
Authors:
Azim S Gangji; Rory Windrim; Shital Gandhi; Jeffrey A Silverman; Christopher T M Chan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  44     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-19     Completed Date:  2005-05-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  912-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Nephrology, Toronto General Hospital and University Health Network, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Hemodialysis Units, Hospital
Humans
Kidney Failure, Chronic / pathology
Night Care*
Pregnancy
Pregnancy Complications / pathology
Pregnancy Outcome*
Renal Dialysis / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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