J Korean Med Sci.  2014 Feb;29(2):301-304. 10.3346/jkms.2014.29.2.301.

Successful Pregnancy in a Patient with Autosomal Dominant Polycystic Kidney Disease on Long-Term Hemodialysis

• Jung JH
• Kim MJ
• Lim HJ
• Sung SA
• Lee SY
• Kim DW
• Lee KB
• Hwang YH

• KMID: 1789993
• DOI: http://doi.org/10.3346/jkms.2014.29.2.301

Abstract

Recent advances in dialysis and a multidisciplinary approach to pregnant patients with advanced chronic kidney disease provide a better outcome. A 38-yr-old female with autosomal dominant polycystic kidney disease (ADPKD) became pregnant. She was undergoing hemodialysis (HD) and her kidneys were massively enlarged, posing a risk of intrauterine fetal growth restriction. By means of intensive HD and optimal management of anemia, pregnancy was successfully maintained until vaginal delivery at 34.5 weeks of gestation. We discuss the special considerations involved in managing our patient with regard to the underlying ADPKD and its influence on pregnancy.

Keyword

Pregnancy; Renal Dialysis; Polycystic Kidney, Autosomal Dominant

MeSH Terms

Adult
Female
Fetal Growth Retardation/etiology
Humans
Kidney Failure, Chronic/therapy
Polycystic Kidney, Autosomal Dominant/*diagnosis
Pregnancy
Renal Dialysis
Risk Factors
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Coronal CT scan taken two years ago shows massively enlarged kidneys filled with numerous cysts and occupying the abdominal and pelvic cavities. Note that there are only a few cysts in the liver.

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  Fig. 2 Clinical course showing dry body weight, predialysis blood urea nitrogen (BUN) and hemoglobin (Hb) levels. HD, hemodialysis; EPO, erythropoietin.

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