Peritoneal Dialysis Initiation to treat end stage kidney desease during pregnancy. A report of 2 cases.
DOI:
https://doi.org/10.25796/bdd.v4i1.60673Keywords:
Female, Kidney Failure, Peritoneal dialysis, Pregnancy, Anti-phospholipidAbstract
Despite strong evidence suggesting that peritoneal dialysis (PD) is a comparable technique to long-hour hemodialysis (HD) for pregnant patients (11,12), few cases are described in the current literature. Moreover, initiating PD in a pregnant woman needing extrarenal epuration is rarely described if at all.
In this article, we present two cases of patients who initiated PD while being already multiple month pregnant: the first one 14 years ago and the other today.
Our two patients are in their thirties, are respectively 16 and 10 weeks pregnant and have a history of anti-phospholipids syndrome. It was decided to start a PD program with both of them. Our first patient gave birth to a healthy 2.5 kg and 45 cm daughter despite an episode of peritonitis and the freeing of the peritoneal catheter from adherences. Our second patient is currently on dialysis without complications and is now 28 weeks pregnant with a healthy monitored child.
Initiating PD in a pregnant patient is a subject that has not yet been published in the current scientific literature. With higher pregnancy rates than ever in the end stage renal disease population (31), we suggest to assess the objective benefits of PD extrarenal epuration method by performing a prospective comparative study between PD and HD.
References
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2. Jakobi P, Ohel G, Szylman P, Levit A, Lewin M, Paldi E. Continuous ambulatory peritoneal dialysis as the primary approach in the management of severe renal insufficiency in pregnancy. Obstet Gynecol 1992; 79:808–10.
3. Piccoli GB, Conijn A, Consiglio V, et al. Pregnancy in dialysis patients: is the evidence strong enough to lead us to change our counseling policy? Clin J Am Soc Nephrol. 2010;5:62–71
4. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002 ; 39: S1-266.
5. Nevis IF, Reitsma A, Dominic A, et al. Pregnancy outcomes in women with chronic kidney disease: a systematic review. Clin J Am Soc Nephrol 2011; 6:2587–98
6. Luders C, Castro MC, Titan SM et al. Obstetric outcome in pregnant women on long-term dialysis: a case series. Am J Kidney Dis. 2010;56(1):77–85
7. Bahadi A, El Kabbaj D, Guelzim K et al. Pregnancy during hemodialysis: a single center experience. Saudi J Kidney Dis Transpl.2010;21(4):646–651
8. Al-Saran KA, Sabry AA. Pregnancy in dialysis patients: a case series. J Med Case Rep. 2008;20(2):10
9. Chou CY, Ting IW, Lin TH, Lee CN. Pregnancy in patients on chronic dialysis: a single center experience and combined analysis of reported results. Eur J Obstet Gynecol Reprod Biol. 2008; 136(2):165–170
10. Malik GH, Al-Harbi A, Al-Mohaya S. Pregnancy in patients on dialysis—experience at a referral center. J Assoc Physicians India. 2005; 53:937–941
11. Hladunewich MA, Hou S, Odutayo A et al. Intensive hemodialysis associates with improved pregnancy outcomes: a Canadian and United States cohort comparison. J Am Soc Nephrol. 2014; 25(5):1103–1109
12. Barua M, Hladunewich M, Keunen J et al. Successful pregnancies on nocturnal home hemodialysis. Clin J Am Soc Nephrol. 2008; 3(2):392–396
13. Nadeau-Fredette AC, Hladunewich M, Hui D, Keunen J, Chan CT. End-stage renal disease and pregnancy. Adv Chronic Kidney Dis. 2013; 20(3):246–252
14. Cabiddu, G., Castellino, S., Gernone, G. et al. Best practices on pregnancy on dialysis: the Italian Study Group on Kidney and Pregnancy. J Nephrol. 2015 2 8, 279–288.
15. Wiles, K., Chappell, L., Clark, K. et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol 20, 401 (2019).
16. E. D. Weinhandl, D. T. Gilbertson, and A. J. Collins, “Mortality, hospitalization, and technique failure in daily home hemodialysis and matched peritoneal dialysis patients: a Matched Cohort study,” American Journal of Kidney Diseases, vol. 67, no. 1, pp. 98–110, 2016
17. Brahmbhatt Y, Ikeme A, Bhogal N, Berghella V. Successful Pregnancy Using the NxStage Home Hemodialysis System. Case Rep Nephrol. 2016;2016:1358625
18. Leduc V, Ficheux M, Bechade C, Dreyfus M, Lobbedez T, Henri P. Pregnancy on short-daily home hemodialysis using low dialysate flow rate: A new hope for the end-stage renal disease patients. Hemodial Int. 2018 Apr;22(2):161-167.
19. Gómez Vázquez JA, Martínez Calva IE, Mendíola Fernández R, Escalera León V, Cardona M, Noyola H. Pregnancy in end-stage renal disease patients and treatment with peritoneal dialysis: report of two cases. Perit Dial Int 2007; 27:353–8.
20. Asam Asamiya Y, Otsubo S, Matsuda Y, et al. The importance of low blood urea nitrogen levels in pregnant patients undergoing hemodialysis to optimize birth weight and gestation age. Kidney Int 2009; 75:1217–22
21. Okundaye I, Abrinko P, Hou S. Registry of pregnancy in dialysis patients. Am J Kidney Dis. 1998;31(5):766–73.
22. Shemin D, Bostom AG, Lambert C, Hill C, Kitsen J, Kliger AS. Residual renal function in a large cohort of peritoneal dialysis patients: change over time, impact on mortality and nutrition. Perit Dial Int. 2000; 20:439–444
23. Lew SQ. Persistent hemoperitoneum in a pregnant patient receiving peritoneal dialysis. Perit Dial Int. 2006; 26:108–110
24. Reddy SS, Holley JL. Management of the pregnant chronic dialysis patient. Adv Chronic Kidney Dis. 2007; 14(2):146–155
25. Tuncer M, Trak B, Sapan M, et al. Successful pregnancy complicated with peritonitis in a 25-year-old Turkish CAPD patient. Perit Dial Int. 2000; 20:349–350
26. Smith WT, Darbari S, Kwan M, O’Relly-Green C, Devita MV. Pregnancy in peritoneal dialysis: a case report and review of adequacy and outcomes. Int Urol Nephrol. 2005;37:145–151.
27. Batarse RR, Steiger RM, Guest S. Peritoneal dialysis prescription during the third trimester of pregnancy. Perit Dial Int. 2015 Mar-Apr;35(2):128-34
28. Hou SH: Pregnancy in women on hemodialysis and peritoneal dialysis. Baillieres Clin Obstet Gynecol. 1994; 8: 481– 500.
29. Schneider K, Ferenczi S, Vas S, Papp Z. Pregnancy and successful full-term delivery in a patient on peritoneal dialysis: One Center’s experience and review of the literature. Dial Transplant. 2007;36:438–444.
30. Successful pregnancies in women treated by dialysis and kidney transplantation. Report from the Registration Committee of the European Dialysis and Transplant Association.Br J Obstet Gynaecol. 1980;87(10):839-45
31. Jungers P, Chauveau D. Pregnancy in renal disease. Kidney Int. 1997 Oct;52(4):871-85.
2. Jakobi P, Ohel G, Szylman P, Levit A, Lewin M, Paldi E. Continuous ambulatory peritoneal dialysis as the primary approach in the management of severe renal insufficiency in pregnancy. Obstet Gynecol 1992; 79:808–10.
3. Piccoli GB, Conijn A, Consiglio V, et al. Pregnancy in dialysis patients: is the evidence strong enough to lead us to change our counseling policy? Clin J Am Soc Nephrol. 2010;5:62–71
4. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002 ; 39: S1-266.
5. Nevis IF, Reitsma A, Dominic A, et al. Pregnancy outcomes in women with chronic kidney disease: a systematic review. Clin J Am Soc Nephrol 2011; 6:2587–98
6. Luders C, Castro MC, Titan SM et al. Obstetric outcome in pregnant women on long-term dialysis: a case series. Am J Kidney Dis. 2010;56(1):77–85
7. Bahadi A, El Kabbaj D, Guelzim K et al. Pregnancy during hemodialysis: a single center experience. Saudi J Kidney Dis Transpl.2010;21(4):646–651
8. Al-Saran KA, Sabry AA. Pregnancy in dialysis patients: a case series. J Med Case Rep. 2008;20(2):10
9. Chou CY, Ting IW, Lin TH, Lee CN. Pregnancy in patients on chronic dialysis: a single center experience and combined analysis of reported results. Eur J Obstet Gynecol Reprod Biol. 2008; 136(2):165–170
10. Malik GH, Al-Harbi A, Al-Mohaya S. Pregnancy in patients on dialysis—experience at a referral center. J Assoc Physicians India. 2005; 53:937–941
11. Hladunewich MA, Hou S, Odutayo A et al. Intensive hemodialysis associates with improved pregnancy outcomes: a Canadian and United States cohort comparison. J Am Soc Nephrol. 2014; 25(5):1103–1109
12. Barua M, Hladunewich M, Keunen J et al. Successful pregnancies on nocturnal home hemodialysis. Clin J Am Soc Nephrol. 2008; 3(2):392–396
13. Nadeau-Fredette AC, Hladunewich M, Hui D, Keunen J, Chan CT. End-stage renal disease and pregnancy. Adv Chronic Kidney Dis. 2013; 20(3):246–252
14. Cabiddu, G., Castellino, S., Gernone, G. et al. Best practices on pregnancy on dialysis: the Italian Study Group on Kidney and Pregnancy. J Nephrol. 2015 2 8, 279–288.
15. Wiles, K., Chappell, L., Clark, K. et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol 20, 401 (2019).
16. E. D. Weinhandl, D. T. Gilbertson, and A. J. Collins, “Mortality, hospitalization, and technique failure in daily home hemodialysis and matched peritoneal dialysis patients: a Matched Cohort study,” American Journal of Kidney Diseases, vol. 67, no. 1, pp. 98–110, 2016
17. Brahmbhatt Y, Ikeme A, Bhogal N, Berghella V. Successful Pregnancy Using the NxStage Home Hemodialysis System. Case Rep Nephrol. 2016;2016:1358625
18. Leduc V, Ficheux M, Bechade C, Dreyfus M, Lobbedez T, Henri P. Pregnancy on short-daily home hemodialysis using low dialysate flow rate: A new hope for the end-stage renal disease patients. Hemodial Int. 2018 Apr;22(2):161-167.
19. Gómez Vázquez JA, Martínez Calva IE, Mendíola Fernández R, Escalera León V, Cardona M, Noyola H. Pregnancy in end-stage renal disease patients and treatment with peritoneal dialysis: report of two cases. Perit Dial Int 2007; 27:353–8.
20. Asam Asamiya Y, Otsubo S, Matsuda Y, et al. The importance of low blood urea nitrogen levels in pregnant patients undergoing hemodialysis to optimize birth weight and gestation age. Kidney Int 2009; 75:1217–22
21. Okundaye I, Abrinko P, Hou S. Registry of pregnancy in dialysis patients. Am J Kidney Dis. 1998;31(5):766–73.
22. Shemin D, Bostom AG, Lambert C, Hill C, Kitsen J, Kliger AS. Residual renal function in a large cohort of peritoneal dialysis patients: change over time, impact on mortality and nutrition. Perit Dial Int. 2000; 20:439–444
23. Lew SQ. Persistent hemoperitoneum in a pregnant patient receiving peritoneal dialysis. Perit Dial Int. 2006; 26:108–110
24. Reddy SS, Holley JL. Management of the pregnant chronic dialysis patient. Adv Chronic Kidney Dis. 2007; 14(2):146–155
25. Tuncer M, Trak B, Sapan M, et al. Successful pregnancy complicated with peritonitis in a 25-year-old Turkish CAPD patient. Perit Dial Int. 2000; 20:349–350
26. Smith WT, Darbari S, Kwan M, O’Relly-Green C, Devita MV. Pregnancy in peritoneal dialysis: a case report and review of adequacy and outcomes. Int Urol Nephrol. 2005;37:145–151.
27. Batarse RR, Steiger RM, Guest S. Peritoneal dialysis prescription during the third trimester of pregnancy. Perit Dial Int. 2015 Mar-Apr;35(2):128-34
28. Hou SH: Pregnancy in women on hemodialysis and peritoneal dialysis. Baillieres Clin Obstet Gynecol. 1994; 8: 481– 500.
29. Schneider K, Ferenczi S, Vas S, Papp Z. Pregnancy and successful full-term delivery in a patient on peritoneal dialysis: One Center’s experience and review of the literature. Dial Transplant. 2007;36:438–444.
30. Successful pregnancies in women treated by dialysis and kidney transplantation. Report from the Registration Committee of the European Dialysis and Transplant Association.Br J Obstet Gynaecol. 1980;87(10):839-45
31. Jungers P, Chauveau D. Pregnancy in renal disease. Kidney Int. 1997 Oct;52(4):871-85.
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2021-02-18
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Jacobs L, Kaysi S, Mesquita M, Fosso C, Carlin A, Brayer I, Dratwa M. Peritoneal Dialysis Initiation to treat end stage kidney desease during pregnancy. A report of 2 cases. Bull Dial Domic [Internet]. 2021 Feb. 18 [cited 2024 Nov. 22];4(1):45-52. Available from: https://bdd.rdplf.org/index.php/bdd/article/view/60673
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Copyright (c) 2021 Lucas Jacobs
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