Peritoneal dialysis prescription during the third trimester of pregnancy.
Management of the pregnant patient on peritoneal dialysis (PD) is potentially challenging because uterine enlargement may negatively affect catheter function and prescribed dwell volumes. Additional reports of the management of these patients are needed. Here, we describe a near-full-term delivery in a 27-year-old woman who had been on dialysis for 7 years. Peritoneal dialysis was continued during the entire pregnancy. In the third trimester, a higher delivered automated PD volume allowed for adequate clearance and control of volume status. A decision to hospitalize the patient to limit activity and facilitate the delivery of increased dialysate is believed to have contributed to the successful outcome for mother and infant. Our report discusses the management of this patient and reviews published dialysis prescriptions used during the third trimester of pregnancy in patients treated with PD.
Nephrology, Hypertension, Transplant Medicine, Rancho Mirage, and University of California San Diego Medical Center, San Diego, California, USA.
Rodolfo R
RR
Batarse
Desert Regional Medical Center, Palm Springs, California, USA.
Ralph M
RM
Steiger
Baxter Healthcare Corporation, Deerfield, Illinois, USA.
Steven
S
Guest
D000328:Adult; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010530:Peritoneal Dialysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011263:Pregnancy Trimester, Third
End-stage renal disease; automated peritoneal dialysis; hemoperitoneum; hypertension; pregnancy