High volume on line hemodiafiltration in dialysis pregnant patients: predilutional or postdilutional?

Although the frequency of pregnancy in women on chronic dialysis is extremely low, it is associated with severe maternal and perinatal morbidity and mortality. This situation represents a challenge for the therapeutic team, which requires multidisciplinary management, as well as measures to adequate...

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Published inJournal of artificial organs Vol. 24; no. 3; pp. 392 - 397
Main Authors Puddu, Marcelo, Migueliz, María Lucía, Rosa-Diez, Guillermo, Crucelegui, Soledad, Martínez, Agustina Heredia, Luxardo, Rosario, Amalfi, Héctor, Egolf, Alicia, Fernandez, María Isabel, Nuñez, Natalia, Canaud, Bernard
Format Journal Article
LanguageEnglish
Published Tokyo Springer Japan 01.09.2021
Springer Nature B.V
Springer Verlag
Subjects
Biomedical Engineering and Bioengineering
Cardiac Surgery
Case Report
Dialysis
Dilution
Female
Hemodiafiltration
Hemodialysis
Hemodynamics
Humans
Hypotension
Life Sciences
Medicine
Medicine & Public Health
Morbidity
Nephrology
Patients
Peritoneal dialysis
Peritoneum
Pregnancy
Renal Dialysis
Renal Insufficiency
Toxins
Uremia
Dialysis in pregnant patients
HVHDF in pregnant patients
HVHDF
High volume on line hemodiafiltration
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Summary:Although the frequency of pregnancy in women on chronic dialysis is extremely low, it is associated with severe maternal and perinatal morbidity and mortality. This situation represents a challenge for the therapeutic team, which requires multidisciplinary management, as well as measures to adequate dialysis treatment. Such efforts include increasing the time and frequency of dialysis session, maintaining low uremia levels and ensuring hemodynamic stability by avoiding intra-treatment arterial hypotension and hydro electrolytic fluctuations. Regarding the dialysis modality, literature makes references to hemodialysis or peritoneal dialysis in pregnancy women, but little is known about the of high volume online hemodiafiltration (HVHDF) as well as the appropriate type of replacement fluid (pre-dilution or post-dilution). We present two cases of patients who were pregnant while being treated with HVHDF modality and had a favorable evolution, where the decision to continue with this dialysis modality was motivated by a best hemodynamic stability and the highest clearance of all types of uremic toxins offered by HVHDF.
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ISSN:1434-7229
1619-0904
DOI:10.1007/s10047-020-01226-4