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NDT Advance Access originally published online on August 22, 2005
Nephrology Dialysis Transplantation 2005 20(11):2537-2542; doi:10.1093/ndt/gfi044
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Brief Report

A systematic approach to managing pregnant dialysis patients—the importance of an intensified haemodiafiltration protocol

Michael Haase1, Stanislao Morgera1, Christian Bamberg2, Horst Halle2, Sebastian Martini1, Berthold Hocher1, Fritz Diekmann1, Duska Dragun1, Harm Peters1, Hans-H. Neumayer1 and Klemens Budde1

Departments of 1 Nephrology and 2 Obstetrics and Gynaecology, Charité University Hospital CCM, Berlin, Germany

Correspondence and offprint requests to: Michael Haase, MD Medizinische Klinik mit Schwerpunkt Nephrologie Campus Charité Mitte Schumannstrasse 20/21 10117 Berlin, Germany. Email: michael.haase{at}charite.de

Background. Pregnancy is still uncommon in women on maintenance dialysis; and their outcomes is reported to have improved to 40% to 85% live births. Here, we report the successful multidisciplinary management of five consecutive pregnant dialysis patients.

Methods. In our centre, we treated each of five patients with a systematically intensified haemodiafiltration protocol, increased erythropoeitin dosages, a generous administration of water-soluble vitamins and trace elements, and a multidisciplinary clinical management approach with a very low threshold for hospitalization.

Results. All patients received haemodiafiltration at least 6 times/week, an average of 28.6±6.3 h/week. We achieved a mean weekly Kt/Vdp of 9.6±1.4 and urea reduction rates of 54.8±29.4%. The mean erythropoeitin dose was increased from 169±94 IU/kg/week prior to admission at our centre to 314±111 IU/kg/week after the initiation of intensified haemodiafiltration. Haemoglobin levels increased from 8.9±1.9 g/dl to 10.7±0.5 g/dl. Mean gestational age at delivery was 32.8±3.3 weeks and mean birth weight was 1765±554 g. The length of hospital stay amounted to 85±61 days for the mothers and 26±18 days for the newborns, and all were discharged healthy.

Conclusions. These modified management guidelines led to favourable outcomes in all our patients, and may help to guide therapy in other pregnant dialysis patients.

Keywords: haemodiafiltration; multidisciplinary management; pregnancy


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 Nephrol Dial TransplantHome page
O. Moranne, V. Samouelian, F. Lapeyre, D. Pagniez, D. Subtil, P. Dequiedt, and E. Boulanger
A systematic approach to managing pregnant dialysis patients--the importance of an intensified haemodiafiltration protocol
Nephrol. Dial. Transplant., May 1, 2006; 21(5): 1443 - 1443.
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