The importance of increased dialysis and anemia management for infant survival in pregnant women on hemodialysis

Despite advances in recent decades, infant survival in pregnant women on hemodialysis remains suboptimal. Asamiya et al. found that higher maternal hemoglobin was associated with successful pregnancy and maternal blood urea nitrogen (BUN) was negatively correlated with infant birth weight and gestational age. Their study suggests that increased or intensive dialysis to achieve predialysis maternal BUN levels <48 mg/dl along with increased doses of erythropoietin to ensure maternal hemoglobin levels >= 9.6 +/- 0.9 g/dl, should be the standard for pregnant women on hemodialysis. Kidney International (2009) 75, 1133-1134. doi:10.1038/ki.2009.14