More pregnant women undergoing kidney dialysis

Kidney dialysis increasing for pregnant women

More expectant mothers are developing kidney failure and beginning dialysis while pregnant, an apparent byproduct of the rise of chronic kidney disease in the United States.

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In a survey of 75 kidney specialists, 43 percent reported that they had treated pregnant women on dialysis. Thirty-two percent of the women began dialysis while pregnant, and 58 percent became pregnant during the first five years of dialysis. Ten percent became pregnant after five years of dialysis.

Twenty-three percent of the pregnancies did not result in a live birth, and 50 percent were complicated by preeclampsia, a condition during pregnancy that is marked by high blood pressure.

Most nephrologists prescribed dialysis for four to four and a half hours a day six days a week.

“Before this survey, it had been more than 15 years since data had been collected on pregnancy outcomes for women on hemodialysis in the United States,” said Dr. Mala Sachdeva of Hofstra North Shore-LIJ School of Medicine.

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“We wanted to provide an update by evaluating the current U.S. experience including overall practice patterns and certain maternal and fetal outcomes that have occurred with this specific patient population.”

The study was presented at a National Kidney Foundation meeting in Dallas on March 26.

The NKF also presented new statistics suggesting that kidney patients on dialysis are surviving longer. Death rates decreased by 15 percent in the first year of treatment in new patients, and by about 19 percent in continuing patients.

"Declining mortality rates are the clearest evidence of improving outcomes in dialysis patients," said lead researcher Eric Weinhandl, principal investigator with the Peer Kidney Care Initiative in Minneapolis.

"The transition to dialysis is difficult, both physically and psychologically," he continued. "However, clinical outcomes on dialysis are improving and patient survival is increasing."

Dr. Kerry Willis, chief scientific officer of the NKF, said, "It is gratifying to see patients living longer on dialysis. Improved practice means that people are initiating dialysis in a generally healthier state, which leads to better long-term outcomes for kidney failure patients."

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