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Kidney Week

Abstract: FR-OR80

Pregnancies in Women with Kidney Failure on Home Dialysis

Session Information

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Shah, Silvi, University of Cincinnati, Cincinnati, Ohio, United States
  • Weinhandl, Eric D., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Leonard, Anthony C., University of Cincinnati, Cincinnati, Ohio, United States
  • Perl, Jeffrey, St Michael's Hospital, Toronto, Ontario, Canada
  • Christianson, Annette, University of Cincinnati, Cincinnati, Ohio, United States
Background

Women with kidney failure have impaired fertility and are at a higher risk of maternal and fetal morbidity and mortality. Little is known about pregnancies in women receiving maintenance home dialysis in the United States.

Methods

Using data from the United States Renal Data System, a cohort of 26,387 women aged 15-49 years with kidney failure receiving maintenance home dialysis in 2005-2018 was examined. We calculated pregnancy rates and identified factors including the modality associated with pregnancy on home dialysis.

Results

Overall, 437 pregnancies were identified in 26,837 women on home dialysis. Unadjusted pregnancy rate was 8.6 per 1000 person-years (PTPY). The unadjusted pregnancy rate was higher on home hemodialysis (16.0 vs. 7.5 PTPY) than on peritoneal dialysis. Women on home hemodialysis had a higher adjusted likelihood of pregnancy than women on peritoneal dialysis (HR, 2.34; 95% CI, 1.79-3.05).
Compared with women aged 20–24 years, the likelihood of pregnancy was lower in women 30-34 years (HR, 0.64; 95% CI, 0.43-0.96), 35–39 years (HR, 0.53; 95% CI, 0.35-0.79), 40–44 years (HR, 0.32; 95% CI, 0.21-0.49), and 45-49 years (HR, 0.21; 95% CI, 0.13-0.33). While Black women had a higher likelihood of pregnancy (HR, 1.40; 95% CI, 1.07-1.83), there was no difference in likelihood of pregnancy in Asian, Hispanic, and Native Americans as compared to Whites. Body mass index, cause of kidney failure, socioeconomic status, rurality, pre-dialysis nephrology care, or dialysis vintage were not significantly associated with pregnancy on home dialysis.

Conclusion

The pregnancy rate in women with kidney failure undergoing home dialysis is higher with home hemodialysis than with peritoneal dialysis. Younger age and Black race/ethnicity are associated with a higher likelihood of pregnancy among women on home dialysis. This information can guide clinicians in preconception counseling and making informed treatment decisions for pregnant women on home dialysis.

Funding

  • Other NIH Support