Pregnancy for patients on dialysis is very rare and raises the risk of pre-term birth and other complications. For decades, patients on dialysis have been counseled by their physician to wait until after a transplant to start or expand their families.
However, a recent case study by Jefferson researchers raises questions about the “one size fits all” approach to pregnancy and dialysis.
“It’s imperative to discuss issues of fertility, conception and pregnancy outcomes with differing types of dialysis with women with chronic kidney disease or end-stage renal disease, especially with women who develop renal failure during their prime child-bearing years” said Dr. Brahmbhatt, a nephrologist at Jefferson. “In addition, we need to further research the safety of pregnancy during short daily home hemodialysis treatments.”
Brandi Williams was diagnosed with focal segmental glomerulosclerosis (FSGS), a rare disease that causes permanent kidney damage, in 2003 at just 21 years old. She chose Jefferson for her care. By 2009, her disease had progressed to the point where she needed to start dialysis, to clean her blood on a daily basis, doing the job that her kidneys no longer could.
She was told that pregnancy is extremely rare in patients who are on dialysis, but in 2012 she found out that she was expecting. Her pregnancy was considered high risk.
Working closely with Dr. Brahmbhatt, Brandi discussed her options for dialysis and maximized her short daily home hemodialysis up to four hours every day. She was monitored extremely closely by both her nephrologist and obstetrician.
At 34 weeks, Brandi delivered a little boy. “He’s my miracle baby,” she said. Today, Jayden is a healthy three-year-old.
In 2015, Brandi received a kidney transplant at a local hospital and is attending nursing school at Aria Health.
“I have a passion to educate patients on the options for dialysis and I want to help them out like my nurses did for me,” she said.
“It’s important that patients on dialysis work closely with their healthcare team if they are considering pregnancy,” Dr. Brahmbhatt said. “Each person’s situation is unique, and pregnancy is rare and very high risk while on dialysis.”