A successful delivery occurred at 30 weeks in a peritoneal dialysis patient, resulting in a live infant and favorable long-term outcomes with careful multidisciplinary management.
Can an individualized peritoneal dialysis regimen and multidisciplinary management result in successful pregnancy and delivery in a patient with end-stage renal disease?
Successful pregnancy and delivery in a patient on maintenance peritoneal dialysis is achievable with individualized dialysis regimens, aggressive comorbidity management, and multidisciplinary care.
Absolute Event Rate: 0% vs 0%
Rationale: Pregnancy in patients undergoing maintenance peritoneal dialysis (PD) is a rare and high-risk clinical scenario with limited documented successful outcomes, necessitating detailed reporting of management strategies. Patient concerns: A 26-year-old woman with end-stage renal disease on maintenance PD for over 5 years presented with an incidentally discovered viable singleton pregnancy at 26⁺ weeks of gestation. Diagnoses: Chronic kidney disease (CKD), Stage 5D (on PD). Pregnancy, singleton, at 26⁺ weeks of gestation. Severe anemia, associated with CKD. Secondary hyperparathyroidism, severe. Hypertension, in the context of CKD. Interventions: An individualized PD regimen (reduced the amount of dialysis per session, increased exchange frequency) was implemented. Comprehensive management included correction of anemia (transfusions, erythropoiesis-stimulating agents, iron supplements), antihypertensive therapy, and control of hyperparathyroidism. Close multidisciplinary surveillance was maintained. Emergency cesarean section was performed at 30⁺ weeks due to fetal distress, preceded by a single hemodialysis session. Outcomes: A live infant (1100 g) was delivered, requiring neonatal intensive care but demonstrating favorable long-term growth and neurodevelopment. The maternal postoperative course was complicated by an intra-abdominal infection associated with the PD catheter, which resolved following its removal. Lessons: Successful pregnancy in PD patients requires meticulous dialysis prescription tailoring, aggressive management of comorbidities, and sustained multidisciplinary collaboration. Postpartum PD catheter removal should be considered to mitigate infectious risk. Favorable maternal and neonatal outcomes are achievable with dedicated, individualized care.
Wang et al. (Fri,) reported a other. A successful delivery occurred at 30 weeks in a peritoneal dialysis patient, resulting in a live infant and favorable long-term outcomes with careful multidisciplinary management.