Key result
Pregnant women on dialysis due to diabetes or lupus had higher composite neonatal morbidity compared to those with other causes of renal failure.
Why the study?
Pregnancy on dialysis is rare with few studies, and outcomes are currently thought to relate to dialysis intensity rather than the underlying cause of renal failure.
Does the underlying cause of renal failure (diabetes or lupus vs. other etiologies) affect peripartum outcomes in pregnant women on dialysis?
Cohort (n=16)
No
Does the underlying cause of renal failure (diabetes or lupus vs. other etiologies) affect peripartum outcomes in pregnant women on dialysis?
In pregnant women on dialysis, underlying renal failure caused by diabetes or lupus is associated with significantly higher neonatal morbidity compared to other etiologies, independent of dialysis intensity.
Answers are grounded in this paper and cite their sources.
Elevated neonatal morbidity risk warrants caution in counseling dialysis patients with diabetes or lupus; leaves open need for prospective etiology-specific studies.
Objective Pregnancy on dialysis is rare and few studies in this population exist. Currently, pregnancy outcomes are thought to be related to dialysis intensity. We hypothesize women requiring dialysis due to diabetes or lupus will have worse pregnancy outcomes compared with other indications for dialysis. Study Design All women receiving dialysis during pregnancy from 2012 to 2016 in a single health system were identified. Differences in perinatal outcomes among those with renal failure caused by diabetes or lupus and with other causes were evaluated. Results Sixteen women were identified, seven with diabetes or lupus causing renal failure; the remaining nine women had hypertension, focal segmental glomerular sclerosis, polycystic kidney disease, congenital hypoplastic kidneys, or neurogenic bladder. The rates of composite maternal morbidity were similar among the two groups. Composite neonatal morbidity was higher in those with renal failure caused by diabetes or lupus compared with other causes (100% vs. 29%, p = 0.028). Conclusion Despite similar dialysis intensity, the composite neonatal morbidity was higher in women with renal failure caused by diabetes or lupus compared with other etiologies. Our findings suggest that pregnancy outcome in women receiving dialysis is dependent on both the intensity of dialysis as well as the etiology of renal failure.
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Hoffman et al. (2020) conducted a cohort in Pregnancy on dialysis (n=16). Renal failure caused by diabetes or lupus vs. Renal failure caused by other etiologies was evaluated on Composite neonatal morbidity (p=0.028). Pregnant women on dialysis due to diabetes or lupus had higher composite neonatal morbidity compared to those with other causes of renal failure.
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