Department of Pharmacy Practice, University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois, USA.
Department of Pharmacy, Rush University Medical Center, Chicago, Illinois, USA.
Hemodial Int. 2023 Jul;27(3):212-223. doi: 10.1111/hdi.13107. Epub 2023 Jun 21.
Successful pregnancy rates on dialysis are increasing with the advent of intensive hemodialysis and advances in medical management.
Data support the use of intensive hemodialysis in pregnant women with end-stage kidney disease (ESKD). This paper provides an overview of common pharmacotherapeutic changes in management when caring for a pregnant woman receiving intensive hemodialysis. Pregnant patients on peritoneal dialysis were excluded from this analysis due to insufficient data. Topics covered include those related to anemia (iron and erythropoietin stimulating agents), blood pressure agents, monitoring of phosphorus, as well as nutrition and anticoagulation.
When patients on hemodialysis become pregnant, medication adjustments are needed regarding antihypertensives, anemia management, and mineral-bone disease management as many agents require dose adjustment, switching agents due to teratogenicity, or cessation due to fetal complications. There are minimal data in this population; however, successful and healthy infants have been delivered in this patient population with the medication changes discussed.
随着强化血液透析和医疗管理的进步，透析患者的妊娠成功率正在提高。
数据支持在患有终末期肾病（ESKD）的孕妇中使用强化血液透析。本文概述了在护理接受强化血液透析的孕妇时，管理方面常见的药物治疗变化。由于数据不足，本文分析中排除了接受腹膜透析的孕妇。涵盖的主题包括与贫血（铁和促红细胞生成素刺激剂）、血压药物、磷监测以及营养和抗凝相关的内容。
当血液透析患者怀孕时，需要调整降压药、贫血管理和矿物质-骨疾病管理方面的药物，因为许多药物需要剂量调整、由于致畸性而更换药物，或因胎儿并发症而停药。在这一人群中，数据很少；然而，在讨论了药物变化后，该患者人群中成功分娩了健康的婴儿。
