Sex problems with renal failure — Having children11. Pregnancy with kidney failure and on dialysis
Sex problems with renal failure — Having childrenThere are so many kidney diseases, that it is not possible to predict every possibility, so a woman wanting information should ask her own specialist. However, there are some generalisations that can be made.
Minor kidney disease usually does not affect pregnancy at all. If a woman has normal kidney function and normal blood pressure with little or no protein in the urine, a pregnancy may proceed perfectly normally. An exception is in some women with a condition called lupus (Click here for information on Lupus & Pregnancy)
If a woman has high blood pressure, this is likely to get worse during pregnancy. Without careful monitoring this could cause problems to the child and mother. A woman with high blood pressure before pregnancy is very likely to deliver prematurely, because of a rise in blood pressure during later pregnancy.
The timing of pregnancy may need some planning for a woman with progressive kidney disease. It may be best to have a child whilst kidney function is quite good (say one half of normal). Waiting until kidney failure is advanced increases the risks, and some women decide to delay pregnancy until after they have received a kidney transplant, because of the risks to their own kidney function and because pregnancy on dialysis has a low success rate.
Women of childbearing age do not often get pregnant whilst on dialysis. This is because dialysis only replaces a small percentage of kidney function, so the body still has high levels of waste products, which interfere with egg production and the menstrual cycle. Once a woman becomes pregnant, high blood pressure almost always causes problems, leading to premature delivery.
In one study performed in the United States, 1.5% (between one and two in a hundred) of young women on dialysis became pregnant in a two year period. Half the pregnancies resulted in the birth of a live child. There were many miscarriages in early pregnancies, and some stillbirths. All living babies were born prematurely.
It is usually recommended that a woman on dialysis who is pregnant should have an increased dialysis dose, be monitored carefully for high blood pressure, and should have a good haemoglobin level maintained with erythropoeitin.
Women who want to have children should consider whether it would be better to use contraception whilst on dialysis, and plan to have children after a kidney transplant. While there are still risks, the likelihood of a successful pregnancy rises to over 70% (seven out of ten) from about 50% (five out of ten) on dialysis. Some women also feel that they would be better able to care for a child if they had a kidney transplant, rather than being on dialysis.
Pregnancy after transplantation
NKF Controlled Document No. 212, Sex problems with renal failure — Having children — 11. Pregnancy with kidney failure and on dialysis, written 15 December 2002. Last reviewed 25 May 2009.
The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.
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Page created: 15 December 2002
Last updated: 29 April 2009
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