Nurses' knowledge and perspectives on pregnancy among dialysis patients

BACKGROUND: Pregnancy on dialysis is a rare and complex event, necessitating careful planning. Nurses play a vital role in the dialysis team, providing essential education and support to patients. This study aimed to explore nurses' knowledge and perspectives regarding pregnancy in dialysis patients. METHODS: An electronic survey was distributed to six dialysis centers in Saudi Arabia, spanning four regions. A total of 127 nurses participated, of whom 88.2% were hemodialysis (HD) nurses and 11.8% were peritoneal dialysis nurses. Survey responses were summarized using descriptive statistics, presented as percentages. RESULTS: Regarding the impact of kidney failure on reproductive health, only 53.5% of respondents recognized it as a cause of menstrual irregularities. However, 82.7% acknowledged that it reduces fertility, and 89% responded "yes" to the possibility of pregnancy while on dialysis, with 61.4% agreeing that female patients of reproductive age with kidney failure require contraception. Despite known limitations, 63% identified a pregnancy test as the preferred method for pregnancy confirmation. In terms of dialysis modality, 63% believed HD to be associated with a higher likelihood of pregnancy. Additionally, 79.5% selected renal transplantation as a measure to increase the likelihood of pregnancy. Regarding pregnancy risks, 89% agreed it poses both fetal and maternal risks. Finally, only 18.1% reported consistently discussing pregnancy-related topics with reproductive-age patients. CONCLUSIONS: Nurses are essential to patient education in the dialysis setting. This study identifies potential knowledge gaps and proposes a framework of learning objectives on reproductive health to be integrated into nursing training.