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透析治疗的慢性肾脏病患者的妊娠问题。

Pregnancy in patients with chronic kidney disease undergoing dialysis.

机构信息

Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil.

Hospital de Base de São José do Rio Preto, São José do Rio Preto, SP, Brazil.

出版信息

J Bras Nefrol. 2024 Oct-Dec;46(4):e20240067. doi: 10.1590/2175-8239-JBN-2024-0067en.

Abstract

Women with chronic kidney disease are less likely to become pregnant and are more susceptible to pregnancy complications when compared to patients with normal kidney function. As a result, these are considered high-risk pregnancies, both maternal and fetal. Over the years, there has been an increase in the incidence of pregnancies in dialysis patients, and an improvement in maternal and fetal outcomes. It is believed that the optimization of obstetric and neonatal care, the adjustment of dialysis treatment (particularly the increase in the number of hours and weekly frequency of dialysis sessions), and the use of erythropoiesis-stimulating agents have provided better metabolic, volume, blood pressure, electrolyte, and anemia control. This review article aims to analyze pregnancy outcomes in chronic kidney disease patients undergoing dialysis and to review nephrological medical management in this scenario. Due to the growing interest in the subject, clinical recommendations for care practice have become more consistent in both drug and dialysis management, aspects that are addressed in this review.

摘要

与肾功能正常的患者相比,患有慢性肾脏病的女性怀孕的可能性较小,并且更容易出现妊娠并发症。因此,这些被认为是母体和胎儿都存在高风险的妊娠。多年来,透析患者的妊娠发生率有所增加,母婴结局也有所改善。人们认为,优化产科和新生儿护理、调整透析治疗(特别是增加透析次数和每周频率)以及使用促红细胞生成素,可提供更好的代谢、容量、血压、电解质和贫血控制。本文旨在分析接受透析的慢性肾脏病患者的妊娠结局,并回顾该情况下的肾脏科医学管理。由于对该主题的兴趣日益增加,在药物和透析管理方面,临床护理实践建议变得更加一致,这也是本文所涉及的方面。

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本文引用的文献

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