Chronic kidney disease in pregnancy requiring first-time dialysis

Abstract

Objective: To report on the treatment and outcome of pregnancy in 29 women with chronic kidney disease (CKD), 24 of whom had moderate or severe renal dysfunction. Methods: Renal dysfunction at the onset of pregnancy was stratified: serum creatinine <= 1.4 mg/dL was defined as mild; 1.5-2.5 mg/dL was defined as moderate; and >2.5 mg/dL was defined as severe renal insufficiency. Clinical complications and perinatal outcomes were evaluated. Results: the average serum creatinine level at the beginning of pregnancy was 3.32 mg/dL (range, 1.2-7.1 mg/dL), and the average urine protein level was 1.51 g in 24 hours (range, 0.1-5.6 g in 24 hours). Dialysis therapy was necessary for 1 woman with mild renal dysfunction, 4 patients with moderate renal dysfunction, and 17 patients with severe renal dysfunction. Conclusion: the use of dialysis in pregnancy among women with moderate or severe renal dysfunction proved to be useful, but many patients became dependent on dialysis. It is not known whether this was due to the interaction between pregnancy and advanced CKD. (C) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.