Al Zahra Hospital, UAE
Title: Current concepts for optimal outcomes of pregnancy in end stage renal disease
Anil K Saxena have over 30 years of experience in Clinical Nephrology including Hemodialysis, Peritoneal dialysis and follow up of renal transplantation and over 20 years of experience in conducting clinical research and publications including four randomised clinical trials on Hemodialysis catheter lock prophylaxis published in reputed Indexed International medical Journals. Published over 75 scientific papers till date. He is the Senior Scientific Advisor at CORMEDIX Incorporation, NJ, USA over 2 years and Member of Editorial Board of The Open Nephrology and Urology Journal, Wake forest university, North Carolina,USA, Member Of National Editorial Board of Saudi Journal of Kidney diseases and Transplantation (SJKDT), Member Of Editorial Board of World Journal of Clinical Urology (WJCU), Beijing,China., Member of Editorial Board of World Journal of Nephrology(WJN), Beijing, China, Member of Editorial Board of Case Reports In Nephrology (CRIN), Hindawi Publications., Member Of ASN (American Society of Nephrology), Fellow of Royal College of Physicians of Ireland, FRCPI, Fellow Of ASN (American Society of Nephrology), FASN, Expert peer reviewer for KI, AJKD, NDT, Hemodialysis International, AJIC, Nephrology, SJKDT
Chronic kidney disease (CKD) affects 195 million women worldwide; 6 % of whom are in childbearing age (20-39 years) while only 3% of pregnant women have kidney disease. The fertility and sexual dysfunction in women with CKD and end stage renal disease (ESRD) on dialysis is considerably compromised: therefore, it is not surprising that conception among women with chronic kidney disease and those on dialysis - is quite rare. The reported incidence of pregnancy has been documented to range from <1% to approximately 7%. Additionally, when pregnancy does occur, it can prove precarious to both mother and baby owing to a multitude of potential complications including accelerated hypertension and preeclampsia, poor fetal growth, anemia, and polyhydramnios.
The first successful pregnancy reported in a patient on chronic hemodialysis, occurred in 1970.The recent data with improved outcomes of high-risk pregnancies among women with ESRD is possibly related to widespread use of erythropoietin stimulating agents and more intensive hemodialysis regimens.
The paradigm of current concept for accomplishing optimal maternal and fetal outcomes in women with ESRD would be discussed in consort with a case -report of successful delivery of a normal healthy baby in an elderly Primigravida on hemodialysis at Al Zahra Hospital, Dubai.