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接受腹膜透析的女性怀孕:管理与透析选择

Pregnancy in a woman undergoing peritoneal dialysis: Management and dialysis options.

作者信息

Veríssimo Rita, Nogueira Estela, Bernardo João, Pereira Marta, Abreu Cristina P, Lopez Noelia, Resina Cristina, Matias Patrícia, Lopes José António, Branco Patrícia, Pinto Luísa

机构信息

Nephrology Department, Centro Hospitalar Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, and.

Equal contribution.

出版信息

Clin Nephrol Case Stud. 2022 Apr 29;10:32-36. doi: 10.5414/CNCS110828. eCollection 2022.

Abstract

Pregnancy in patients with end-stage renal disease on maintenance dialysis is uncommon, with annual incidences reported at 0.3 - 2.7%. Peritoneal dialysis usage in pregnancy has been less reported than hemodialysis, although outcomes are similar. Nowadays, there are insufficient data to establish a generalizable dialysis strategy in pregnant women with end-stage renal disease. As such, decisions should be individualized, depending on clinical factors, residual renal function, and, whenever possible, choice of the patient. We report the case of a 22-year-old patient receiving peritoneal dialysis who delivered a full-term, normal weight, healthy baby with increased dialysis dose achieved by supplementary hemodialysis during pregnancy, thus enabling peritoneal dialysis to be continued until the third trimester and minimizing hemodialysis requirements.

摘要

维持性透析的终末期肾病患者怀孕并不常见,年发病率报道为0.3%-2.7%。与血液透析相比,腹膜透析在妊娠中的使用报道较少,尽管结果相似。目前,尚无足够数据来确立针对终末期肾病孕妇的通用透析策略。因此,决策应个体化,取决于临床因素、残余肾功能,并尽可能考虑患者的选择。我们报告了一例22岁接受腹膜透析的患者,她分娩了一个足月、体重正常、健康的婴儿,通过孕期补充血液透析增加了透析剂量,从而使腹膜透析能够持续到孕晚期,并将血液透析需求降至最低。

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本文引用的文献

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End-Stage Kidney Disease and Dialysis in Pregnancy.终末期肾病与妊娠期间的透析治疗。
Adv Chronic Kidney Dis. 2020 Nov;27(6):477-485. doi: 10.1053/j.ackd.2020.06.001.
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Pregnancy and End-Stage Renal Disease.妊娠与终末期肾病。
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