Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4521-4526
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4521
Successful pregnancy after protective hemodialysis for chronic kidney disease: A case report
Meng-Lu Wang, Ying-Dong He, Hui-Xia Yang, Qian Chen
Meng-Lu Wang, Ying-Dong He, Hui-Xia Yang, Qian Chen, Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
Author contributions: Wang ML, He YD, and Yang HX were the patient's obstetricians and reviewed the literature; Wang ML contributed to manuscript drafting; Chen Q was responsible for the revision of the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for hospitalization and treatment.
Conflict-of-interest statement: None of the authors have any potential conflicts of interest to declare regarding this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qian Chen, MD, Doctor, Department of Obstetrics and Gynecology, Peking University First Hospital, No. 1 Xi' anmen Road, Xicheng District, Beijing 100034, China. chenqianobs@126.com
Received: June 30, 2020
Peer-review started: June 30, 2020
First decision: August 8, 2020
Revised: August 10, 2020
Accepted: August 26, 2020
Article in press: August 26, 2020
Published online: October 6, 2020
Processing time: 89 Days and 9.4 Hours
Abstract
BACKGROUND

Chronic kidney disease (CKD) affects almost 3% of females of child-bearing age, who have a high risk of adverse maternal and fetal outcomes. Additionally, high renal burden as a result of pregnancy may lead to deterioration of renal function. An increasing number of women with CKD stages 3 to 5 have a strong desire to conceive, and both obstetricians and nephrologists are faced with enormous challenges in terms of their treatment and management.

CASE SUMMARY

The case of a 35-year-old pregnant woman with a 10-year history of mild mesangial proliferative glomerulonephritis is described here. CKD progressed from stage 3 to stage 5 rapidly during pregnancy, and protective hemodialysis was started at 28 wk of gestation. Due to preeclampsia at 34 wk of gestation, cesarean section was performed and a healthy baby was delivered. Hemodialysis was discontinued at 4 wk postpartum. After 1 year of follow-up, her renal function was stable, and her baby exhibited good growth and development.

CONCLUSION

Protective hemodialysis during pregnancy can prolong gestational age and improve maternal and fetal outcomes in women with advanced CKD.

Keywords: Pregnancy; Obstetrics; Chronic kidney disease; Hemodialysis; Nephrology; Case report

Core Tip: Chronic kidney disease (CKD) affects almost 3% of females of child-bearing age, who have a high risk of adverse maternal and fetal outcomes. Only scarce cases of protective hemodialysis for CKD during pregnancy have been reported. We present herein the first case of successful pregnancy after protective hemodialysis for CKD in our institution. This case highlights the ultimate importance of protective hemodialysis. Protective hemodialysis during pregnancy can prolong gestational age and improve maternal and fetal outcomes in women with advanced CKD.