Hemodiafiltration, an opportunity for life, to create life.
A case report.
DOI:
https://doi.org/10.56867/Keywords:
Pregnancy, Renal Dialysis, Mortality, Case ReportsAbstract
Introduction: The possibility of achieving a pregnancy in women with lupus nephropathy undergoing hemodialysis treatments is very low, between 0.4% and 1.4%.
Clinical case: A 27-year-old woman with lupus nephropathy who, during the hemodialysis program, was diagnosed with a high-risk 7-week pregnancy. The modality was changed to daily post-dilution Hemodiafiltration (HDF) with an extracorporeal flow of 450 ml/min. She received aspirin 100 mg QD, calcium carbonate 1 g PO Qd, and alpha methyldopa 250 mg every 8 hours until week 37. 13 prenatal check-ups were performed. The usual ultrafiltration was 500 ml per treatment. The dry weight at the beginning of the pregnancy was 91.8 kilos (7th gestational week); at the end, it was 100.0 kilos.
Evolution: A 2200 gr girl was obtained by segmental cesarean section, height: 45 cm, head circumference: 32 cm, abdominal circumference of 27 cm, APGAR score 8-8-9, and Ballard scale of 37 weeks, with the ideal maternal condition without superimposed hypertensive disorders, or events related to active immunity.
Conclusion: In the present case, online post-dilution hemodiafiltration therapy was the option for a woman with lupus nephropathy with stage 5-d chronic kidney disease of childbearing age and wishing to become pregnant. Due to the proven advantages of hemodiafiltration due to greater clearance and hemodynamic stability, both maternal and fetal, it is recommended as a treatment for high-risk pregnancy.

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Copyright (c) 2023 José Dorta Díaz, Harold Alvarez, Juan Pérez Chill, Verónica Alvarado Ereú, Pedro Amador Guillen (Author)

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