Conception and Pregnancy in Peritoneal Dialysis Patients

Fertility is markedly reduced in dialysis patients. Estimates of the frequency of conception in dialysis patients range from 1.4% per year in Saudi Arabia (1) to 0.5% in the United States (2). Both of those estimates are based on surveys that covered only half the women of childbearing age treated with dialysis. A report from Belgium, based on a survey to which all the dialysis units in the country responded, put the frequency at 0.3% per year (3). The U.S. Registry for Pregnancy in Dialysis Patients (RPDP) separates hemodialysis patients from peritoneal dialysis patients and notes that conception occurs in peritoneal dialysis at slightly less than half the rate of its occurrence in hemodialysis patients. Those rates of conception do not take into account whether women are sexually active, using contraception, or have reasons for infertility other than renal failure (such as previous treatment with cyclophosphamide). The reasons for the rarity of pregnancy in dialysis patients are not well understood. Of women dialysis patients of childbearing age, 42% report having menses, but approximately half of those have irregu