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Review
. 2024 Oct-Dec;46(4):e20240067.
doi: 10.1590/2175-8239-JBN-2024-0067en.

Pregnancy in patients with chronic kidney disease undergoing dialysis

[Article in English, Portuguese]
Fernanda Salomão Gorayeb-Polacchini  1   2 , Ana Flavia Moura  1   3 , Claudio Luders  4 , José Andrade Moura Neto  1   3 , Juliana El Ghoz Leme  1   5 , Dirceu Reis da Silva  1   6
Affiliations
Review

Pregnancy in patients with chronic kidney disease undergoing dialysis

[Article in English, Portuguese]
Fernanda Salomão Gorayeb-Polacchini et al. J Bras Nefrol. 2024 Oct-Dec.

Abstract
in English, Portuguese

Women with chronic kidney disease are less likely to become pregnant and are more susceptible to pregnancy complications when compared to patients with normal kidney function. As a result, these are considered high-risk pregnancies, both maternal and fetal. Over the years, there has been an increase in the incidence of pregnancies in dialysis patients, and an improvement in maternal and fetal outcomes. It is believed that the optimization of obstetric and neonatal care, the adjustment of dialysis treatment (particularly the increase in the number of hours and weekly frequency of dialysis sessions), and the use of erythropoiesis-stimulating agents have provided better metabolic, volume, blood pressure, electrolyte, and anemia control. This review article aims to analyze pregnancy outcomes in chronic kidney disease patients undergoing dialysis and to review nephrological medical management in this scenario. Due to the growing interest in the subject, clinical recommendations for care practice have become more consistent in both drug and dialysis management, aspects that are addressed in this review.

Resumo: As mulheres portadoras de doença renal crônica apresentam menor probabilidade de engravidar e são mais propensas a complicações gestacionais quando comparadas a pacientes com função renal normal, sendo, portanto, consideradas gestantes de alto risco materno e fetal. Ao longo dos anos, verificou-se aumento da incidência de gestações em pacientes em diálise e melhora do desfecho materno e fetal. Acredita-se que a otimização do atendimento obstétrico e neonatal, o ajuste do tratamento dialítico (em especial, o aumento do número de horas e da frequência semanal das sessões de diálise) e o uso de agentes estimuladores da eritropoiese têm proporcionado melhor controle metabólico, volêmico, pressórico, eletrolítico e da anemia. Este artigo de revisão tem o objetivo de analisar os desfechos gestacionais em pacientes com doença renal crônica em diálise e revisar a condução médica nefrológica nesse cenário. Pelo crescente interesse pelo tema, as recomendações clínicas para a prática assistencial têm ganhado em consistência tanto no manejo medicamentoso quanto no manuseio dialítico, aspectos que tratamos na presente revisão.

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Conflict of interest statement

Conflict of Interest

The authors declare that they have no conflict of interest related to the publication of this manuscript.

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