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Pregnancy is a wonderful time in a mother's life but unfortunately, not every woman will be able to have children for one reason or another. Fertility factors come into play in most of these circumstances but there is a group of patients who still may be fertile, but have another contraindication for getting pregnant. A group where the traditional line of thought was to discourage pregnancy was in patients suffering from kidney disease and requiring dialysis. 

A surface connection that most patients can make is that pregnancy is discouraged in these group because pregnancy is a very demanding process on the physiology of a woman and if she already has another severe disease, pregnancy would not be advised. 

Another consideration that most patients miss is how vital kidneys are during pregnancy. The mother is now not only responsible for cleaning and filtering her own blood, but she must also clean and filter the blood of her fetus, and any damage on kidneys requiring dialysis could hasten the process of renal failure. 

Not only will the kidneys potentially be affected, but mothers may also have a more challenging pregnancy and the fetus is more likely to suffer from complications during the developmental phase. Not long ago, it was believed that of all the pregnancies that occurred in patients suffering from end-stage renal disease, only about 25 percent of cases actually survived. 

Even if patients with dialysis will have a much more challenging road than a mother without kidney problems during pregnancy, that does not mean that it is impossible to have a viable pregnancy while on dialysis. Due to advancements in modern medicine, patients under strict control during these pregnancies have now been reported to have successful births over 70 percent of the time. 

Some of the more consistent observations would be that mothers suffering from ESRD and requiring hemodialysis had high blood pressures during a pregnancy. High blood pressure is something that most patients can live with and treat while they are not pregnant but when you are pregnant, even slightly elevated blood pressure can lead to growth retardation in the fetus. Most babies of mothers on dialysis will be smaller than the typical baby and this fact will usually mean that babies will have to spend the first weeks of their lives living in a NICU while they develop. 

Mothers who choose to carry out a pregnancy while on dialysis must be aware that there are some inherent risks of choosing to do this. Some of the most common complications would be miscarriages, placental detachments, preeclampsia and the need for emergency C-sections. Even with all these risks, studies show that maternal mortality rates during pregnancy were only 1 percent, which is an encouraging statistic. 

There are no definite contraindications for a mother on dialysis not to get pregnant. However, your obgyn must warn you that this will be a very challenging road and there are many different ways for the pregnancy not to end well. On the other hand, success is also possible with close medical observation. [1]

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