title: [Pregnancies in hemodialysis and in patients with end-stage chronic kidney disease : epidemiology, management and prognosis].
abstract: Pregnancy in patients presenting end-stage renal disease is rare and there are currently no recommendations for the management of these patients. In hemodialysis patients, reduced fertility and medical reluctance limit the frequency of pregnancies. Although the prognosis has significantly improved, a significant risk for unfavorable maternal (pre-eclampsia, eclampsia) and fetal (pre-term birth, intrauterine growth restriction, still death) outcome still remains. Increasing dialysis dose with the initiation of daily dialysis sessions, early adaptation of medications to limit teratogenicity and management of chronic kidney disease complications (anemia, hypertension) are required. A tight coordination between nephrologists and obstetricians remains the central pillar of the care. In peritoneal dialysis, pregnancy is also possible with modification of the exchange protocol and reducing volumes.
authors.affiliation: Service de néphrologie, hôpital Édouard-Herriot, pavillon P, 5, place d'Arsonval, 69003 Lyon, France. Electronic address: marine.panaye@chu-lyon.fr.
authors.forename: Marine
authors.initials: M
authors.lastname: Panaye
authors.affiliation: Service de néphrologie, hôpital Édouard-Herriot, pavillon P, 5, place d'Arsonval, 69003 Lyon, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Jolivot
authors.affiliation: Service de néphrologie, hôpital Édouard-Herriot, pavillon P, 5, place d'Arsonval, 69003 Lyon, France; Université Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Lemoine
authors.affiliation: Service de néphrologie, hôpital Édouard-Herriot, pavillon P, 5, place d'Arsonval, 69003 Lyon, France.
authors.forename: Fitsum
authors.initials: F
authors.lastname: Guebre-Egziabher
authors.affiliation: Université Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France; Service gynécologie obstétrique, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69500 Bron, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Doret
authors.affiliation: Université Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France; Service transplantation et immunologie clinique, hôpital Édouard-Herriot, pavillon P, 5, place d'Arsonval, 69003 Lyon, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Morelon
authors.affiliation: Service de néphrologie, hôpital Édouard-Herriot, pavillon P, 5, place d'Arsonval, 69003 Lyon, France; Université Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Juillard
mesh_terms: D005260:Female; D005298:Fertility; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011379:Prognosis; D006435:Renal Dialysis; D027724:Reproductive Techniques, Assisted
keywords: Chronic kidney disease; Dialyse péritonéale; Grossesse; Hemodialysis; Hémodialyse; Kidney transplantation; Maladie rénale chronique; Pregnancy; Transplantation rénale; peritoneal Dialysis