Successful pregnancies in dialysis patients including those suffering from cystinosis and familial Mediterranean fever.
For women on maintenance dialysis, pregnancy is still uncommon. The outcome of such pregnancies has improved in recent case series. Here, we report in detail the treatment of five successful pregnancies in dialysis patients from our centre. The present case series also includes the first successful pregnancy of a dialysis patient with underlying familial Mediterranean fever, and of a dialysis patient with cystinosis. We treated all patients with an intensified hemodiafiltration protocol, increased erythropoietin dosages, a generous application of water-soluble vitamins and trace elements in addition to a multidisciplinary clinical management approach with a very low threshold for hospital admission. Specifically, we report treatment of arterial hypertension with respect to changes in dry weight and pharmacological therapy. Mean gestational age at delivery was 32.8+/-3.3 weeks and mean birth weight was 1,765+/-554 g. All mothers and newborns were discharged healthy and in good condition. These modified management guidelines have led to a favourable outcome in all our patients including two patients with familial Mediterranean fever and with cystinosis, and may help to guide therapy in other pregnant dialysis patients.
Haase
Michael
M
Department of Nephrology, Charité University Medicine, Berlin-Germany.
Morgera
Stanislao
S
Bamberg
Christian
C
Halle
Horst
H
Martini
Sebastian
S
Dragun
Duska
D
Neumayer
Hans-H
HH
Budde
Klemens
K
D000328:Adult; D001724:Birth Weight; D003554:Cystinosis / Q000628:therapy*; D004921:Erythropoietin / Q000008:administration & dosage*; D010505:Familial Mediterranean Fever / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D017583:Hemodiafiltration; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D014131:Trace Elements / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage*
D014131:Trace Elements; D014815:Vitamins; D004921:Erythropoietin