In the last ten years or so, some of my students developed lupus, which they inherited from their parents. So far both students have non-active lupus which doesn’t usually affect their kidneys. However, they have to be monitored frequently in case their kidneys ever start to show signs of failing and since both are female, they will probably be high risk patients whenever they decide to have children. Though lupus comes with its own pregnancy issues, chronic kidney disease or failure can have even more severe consequences, especially if the women eventually need dialysis.

A study conducted by the Central and Northern Adelaide Renal and Transplantation Service of the Royal Adelaide Hospital in Australia has found that women who need dialysis will have a better chance of delivering healthy children if they start the treatment after conception, not before.

Many women with chronic kidney disease (CKD) are often discouraged from having children because the process will likely cause their kidneys to deteriorate more rapidly and could also cause hypertension and increase the chances of having a stillborn child or a child with low birth weight. Despite these risks however, many women still take the chances and even successfully have healthy children. More often than not though, there will be significant consequences for both the mother and child.

In order to find a safer way for women with CKD to have children, Dr. Shilpa Jesudason and her colleagues examined the dialysis process and found that women who delay chronic dialysis until after conceiving have a better chance of delivering live children. The researchers analyzed pregnancies reported to the Australian and New Zealand Dialysis and Transplantation Registry from 2001 to 2011 and ended up with reports from 77 pregnancies. Out of these women, 53 conceived after receiving dialysis and 24 conceived before receiving dialysis.

The women who started dialysis afterwards had a live birth rate of 91% compared to the other group who had a rate of 63%. However, both groups of women had children that were typically below birth weight and were an average of about 3.86 pounds. The main findings through the study showed that while starting dialysis after conceiving helped improve the chances of live birth, it didn’t usually make a difference in birth weight.

Dr. Jesudason commented that ultimately their study was useful to provide information “that can help counsel women with renal failure who want to get pregnant, or who become pregnant and want to make decisions about the pregnancy."

Source: American Society of Nephrology (ASN) (2013, November 14). Starting dialysis after conception may improve birth rates. ScienceDaily.

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