Evidence map›Paper›PMID 41394018›Full record

ArticleCase reports in nephrology and dialysis

Adaptive Hemodiafiltration Strategies in a Full-Term Pregnancy with End-Stage Kidney Disease: A Case Report.

Masato Sakai, Erika Hishida, Manabu Ogura, Takahiro Masuda, Manabu Ogoyama, Toshimi Imai, Tetsu Akimoto, Hiroshi Satonaka, Hironori Takahashi, Hiroyuki Fujiwara and 1 more

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Article in Case reports in nephrology and dialysis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Masato SakaiDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
Erika HishidaDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
Manabu OguraOgura Internal Medicine and Kidney Clinic, Oyama, Japan.
Takahiro MasudaDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
Manabu OgoyamaDepartment of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan.
Toshimi ImaiDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
Tetsu AkimotoDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
Hiroshi SatonakaDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
Hironori TakahashiDepartment of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan.
Hiroyuki FujiwaraDepartment of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan.
Daisuke NagataDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Managing pregnancy in patients with end-stage kidney disease (ESKD) undergoing dialysis is challenging, with hypoalbuminemia significantly increasing risks to both maternal and neonatal outcomes. Intensive hemodialysis regimens are recommended; however, individualized and adaptive dialysis strategies, such as sequential online hemodiafiltration (OL-HDF) and intermittent HDF (i-HDF), may be required to optimize care in complex cases. Case Presentation: We report the case of a 27-year-old Japanese woman with ESKD who transitioned from OL-HDF to i-HDF during pregnancy due to progressive hypoalbuminemia at 30 + 5 weeks of gestation. Dry weight adjustments were guided by human atrial natriuretic peptide (hANP) levels, blood pressure measurements, and bioimpedance analysis. i-HDF reduced albumin loss compared to OL-HDF, stabilized maternal hemodynamics, and enabled term delivery at 39 + 1 weeks with a healthy neonate weighing 2,774 g. Bioimpedance analysis and hANP-guided adjustments allowed for precise fluid management, resulting in a total gestational weight gain of 6.4 kg. The patient developed superimposed preeclampsia during labor, which was successfully managed. Conclusion: This case demonstrates that sequential OL-HDF and i-HDF can effectively address hypoalbuminemia and fluid imbalances, contributing to successful maternal and neonatal outcomes in ESKD pregnancies.

Indexed as

End-stage kidney diseaseHypoalbuminemiaIntermittent hemodiafiltrationMaintenance hemodialysisSequential hemodiafiltrationTerm delivery

Identifiers

PMID41394018
PMCPMC12700590

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