Successful pregnancy in peritoneal dialysis: a case report

Abstract

Introduction: Conception in dialysis patients is a rare event. In peritoneal dialysis (PD), it is exceptional due to the technique’s short half-life, as these are young women who are often waiting for a transplant project. Clinical observation: We report a case of successful pregnancy conducted exclusively on peritoneal dialysis in a patient on PD for 2 years with preserved residual renal function. At the beginning of pregnancy, our patient was on continuous ambulatory peritoneal dialysis (CAPD), and at 12 weeks of amenorrhea (WA), we indicated automated peritoneal dialysis (APD) for better fluid and sodium depletion and adequate dialysis. The delivery was programmed at 35 WA per caesarian section, which gave birth to a newborn weighing 3.5 kg and with an Apgar index of 10/10. CAPD was resumed 2 weeks later. After 4 years of follow-up, the child is in good health, and our patient is on APD. Discussion: In peritoneal dialysis, pregnancy remains a rare but possible event. It requires regular adaptation of the prescription of dialysis and a close clinical and biological follow-up to improve the maternal-fetal prognosis. Conclusion: Successful pregnancy in PD requires multidisciplinary care. The prognosis has improved thanks to advances in the technique (APD, extrarenal) and the introduction of erythropoietin. However, the data are insufficient, and more recent studies on larger numbers are needed.