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NDT Advance Access originally published online on November 22, 2005
Nephrology Dialysis Transplantation 2006 21(5):1443; doi:10.1093/ndt/gfi287
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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

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

Email: olivier.moranne{at}wanadoo.fr

Sir,

We read with interest the paper by Haase et al. [1] reporting five successful consecutive pregnancies in patients on maintenance dialysis, as it closely parallels our experience.

We have indeed reported [2] seven consecutive pregnancies occurring between 1995 and 2001 in patients on dialysis for >1 year. The frequency and length of sessions, and haemoglobin targets, were systematically increased. One patient chose to terminate her pregnancy. The mean gestational age for the six other pregnancies was 31 weeks (24–34 weeks) with an average birth weight of 1495 g. One neonate born at 24 weeks died 2 days following delivery. Paediatric evaluation of the five other children showed a good outcome after up to 5.5 years.

We must, however, disagree with the statement that haemodiafiltration is the preferred treatment in pregnancy, as all our patients were on haemodialysis. Further studies are certainly necessary to identify the importance of factors such as dialysis technique and biological targets, but lack of availability of haemodiafiltration should not be a deterrent to taking charge of these pregnancies. In our opinion, as in that of Haase et al., it is indeed the quality of the collaboration between obstetricians, paediatricians and nephrologists that determines the outcome of pregnancy in patients on maintenance dialysis.

Conflict of interest statement. None declared.

Olivier Moranne1, Vanessa Samouelian2, Fabrice Lapeyre3, Dominique Pagniez1, Damien Subtil2, Philippe Dequiedt1 and Eric Boulanger1

1 Department of Nephrology2 Department of Obstetrics3 Department of Neonatology Lille Hospital France

References

  1. Haase M, Morgera S, Bamberg C et al. A systematic approach to managing pregnant dialysis patients—the importance of an intensified haemodiafiltration protocol. Nephrol Dial Transplant 2005; 20: 2537–2542[Abstract/Free Full Text]
  2. Moranne O, Samouelian V, Lapeyre F et al. Pregnancy and hemodialysis. Nephrologie 2004; 25: 287–292[Medline]

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
21/5/1443    most recent
gfi287v1
Right arrow Alert me when this article is cited
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Right arrow Articles by Moranne, O.
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Right arrow Articles by Boulanger, E.
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