Peritoneal Dialysis in Pregnancy-A Reflection on the Occasion of World Kidney Day.

Abstract

Pregnancy in women affected by chronic kidney disease (CKD) has been and still is very challenging, with an increased risk of negative outcome compared with the overall population. Higher risk of developing hypertension and proteinuria, as well as preterm delivery, are all complications that are often observed, especially in late CKD stages, and can have a detrimental impact on the future health of the mother and the baby. Fertility may also be affected in kidney patients, advanced CKD in particular causing a decrease in fertility (1). Over the last decades, rates of successful pregnancy in CKD patients on dialysis have increased substantially. This is mainly due to changes in dialysis therapy and the more comprehensive management of pregnant dialysis patients. More intensive dialysis is associated with better outcomes for mother and fetus, irrespective of the type of dialysis (2). In peritoneal dialysis (PD), this generally requires the use of high-dose automated PD (3–4). World Kidney Day is a global awareness campaign aimed at raising awareness of the importance of our kidneys. In 2018, World Kidney Day and International Women’s Day 2018 are commemorated on the same day, offering the opportunity to reflect on the importance of women’s health and specifically their renal health. Particular relevance is given to maternal and child health in kidney patients, as there is a clear need for more education and awareness of CKD in pregnancy. Ideally, kidney patients should seek preconception counseling, physicians should provide timely diagnosis of CKD and associated conditions, and proper follow-up during and after pregnancy should always be offered and asked for. On its 13th anniversary, World Kidney Day promotes affordable and equitable access to health education, healthcare, and prevention for kidney diseases for all women and girls in the world.