Dialysis during pregnancy in advanced chronic renal failure patients: outcome and progression.

Successful pregnancies in uremic women are rare. Early initiation of regular hemodialysis in pregnant moderately uremic women is debatable. We chose regular hemodialytic treatments in 2 pregnant patients with stable renal failure with the aim of improving fetal outcome. The first patient with reflux nephropathy arrived at our clinic in the 18th week of her second pregnancy, having a serum creatinine level of 4.5 mg/100 ml and a creatinine clearance (Ccr) of 15 ml/min. Regular hemodialysis was carried out from the 29th gestational week until delivery. A healthy female infant was born weighing 1,095 g at the end of the 36th week of pregnancy. The second patient had an immune complex nephritis with a serum creatinine of 4.2 mg/100 ml and a Ccr of 18 ml/min. Hemodialysis was performed regularly from the 13th gestational week until the 37th week and stopped when normal labor developed and a healthy female infant weighing 2,145 g was born. We believe that the early initiation of regular hemodialysis in these 2 patients contributed significantly to the successful outcome of their pregnancies.