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Birth Rates Improves if Dialysis Is Initiated after Conception

newsA study appearing on an upcoming issue of the Clinical Journal of the American Society of Nephrology reports that people starting dialysis after conception than those already on dialysis at the time of conception. The findings provide valuable information for counseling women with kidney disease who are of child-bearing age.

Women with chronic kidney disease(CKD) often experience increased risks including high blood pressure and worsening of kidney disease.As for the babies,premature delivery, low birth weight and pregnancy can occur. Due to those risks,women with CKD are strongly discouraged from becoming pregnant. However,intense care and monitoring have improved outcomes in these high-risk pregnancies.

Shilpa Jesudason MBBS,FRACP,PhD (Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital,in Australia) and her colleagues investigated the outcomes of pregnancies in women with advanced CKD who were receiving chronic dialysis treatment in Australia and New Zealand.In the study, women who conceived before starting dialysis were compared with women who conceived after starting chronic dialysis.

The major finding of the study includes:

*The live birth rate was 73% overall

*Premature delivery occurs in 82% of pregnancies

*Compared with women who conceived after being starting dialysis, women who conceived before starting dialysis had a much better live birth rate.

*In both groups,premature delivery and low birth weight commonly occur.

Conclusion: The conclusion of the study is that women with advanced kidney disease who start chronic dialysis after conception have superior live birth rate to those already established on dialysis at the time of conception,although these remain high-risk pregnancies.Dr. Jesudason noted that it is an ideal choice for a woman with advanced put off a pregnancy until a kidney transplant is received. The study provides information that can help counsel women with kidney failure who want to get pregnant, or who become pregnant and want to make decisions about the pregnancy.

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