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. 2014 Feb;7(1):57-8.
doi: 10.1093/ckj/sft155. Epub 2014 Jan 12.

Dialysis for twins

Ann-Maria Gramkow  1 , Michael Aarup  1 , Lise Lotte Torvin Andersen  2 , Martin Tepel  3
Affiliations

Dialysis for twins

Ann-Maria Gramkow et al. Clin Kidney J. 2014 Feb.

Abstract

A 32-year-old woman with known stage-4 chronic kidney disease due to lupus nephritis presented with twin pregnancy after in vitro fertilization at a gestational age of 24 weeks + 3 days because of imminent preterm labour. Repeated ultrasound evaluations confirmed intrauterine growth restriction in both twins and polyhydramnios as the cause of imminent preterm labour. After initiation of haemodialysis treatment, ultrasound evaluation showed a significant decrease in amniotic fluids, and also reduction in blood urea nitrogen and in clinical complaints could be observed. At a gestational age of 28 weeks + 4 days, delivery was performed by Caesarean section. This case study shows that effective treatment of elevated uraemic toxins significantly reduced the morbidity risks of the twins.

Keywords: chronic kidney disease; dialysis; pregnancy; twins.

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Figures

Fig. 1.
Fig. 1.
Example for the determination of amniotic fluid volume using the single deepest pocket measurement (dotted line in A) and change of blood urea nitrogen (B) in a woman with known chronic kidney disease, presenting with twin pregnancy and imminent preterm labour, before and after starting haemodialysis treatment. (C) Twins after delivery at a gestational age of 28 weeks + 4 days.
See this image and copyright information in PMC

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