Two happy endings to pregnancies with CKD

Khadija became pregnant with her first child at the age of 22, shortly after being diagnosed with CKD. Despite all warnings, she continued the pregnancy and had to begin dialysis three months after giving birth to her son. She remembers the support from Dr. Mora at the Fresenius Medical Care dialysis centre in Granollers near Barcelona when she became pregnant again five years later: “I thought Dr. Mora was going to be angry with me for putting my life and the life of my unborn child at risk again, but when I told him, he calmed me down, supported me and gave me the strength to continue.”

Dr. Mora explains: “For patients like Khadija there are many concerns, for instance, the possibility of the pregnancy triggering health complications or special measures that they need to follow. Khadija’s weekly dialysis sessions were increased from three to six, paying special attention to liquid control and her blood pressure.” He also explains how doctor-patient communication and therapy are two key aspects to avoiding complications: “From the very first moment Khadija understood that she had to follow a set of medical instructions, slightly different from her usual ones, such as daily dialysis. She was eager to collaborate and knew that it was for the sake of both herself and her unborn child. She collaborated until the end, which resulted in a successful pregnancy and birth.”

In Durban, Lungisile Mbali Manqele welcomed two bouncing bundles of joy named Nknyezi and Kwezi. This brother and sister duo have defied all odds and are one of the very first sets of twins to be born to a mother who is currently on dialysis treatment.

Staff at the Durban Kidney & Dialysis Centre explain that this is indeed a miracle, as, from a science perspective, the elevated levels of urea creatinine accompanied by a minimal to nil urine output would normally make a successful pregnancy, let alone twins, nearly impossible. Women who are on dialysis treatment are made aware early on that renal failure severely decreases the chances of a successful pregnancy. In fact Lungisile, Fresenius Medical Care dialysis patient of three years, only discovered that she was expecting when she was already 17 weeks into her pregnancy. She had attributed what were in fact pregnancy symptoms to the common cold, changes in her dry weight and even food poisoning. It was only through a blood test that her pregnancy was confirmed. When Lungisile had her first ultrasound, she was even more surprised to discover that she was carrying not one but two babies.

Lungisile had her babies delivered at Netcare St. Augustine hospital via a C-section seven months into her pregnancy. During her second trimester, her dialysis prescription was changed to daily dialysis and two weeks before her set delivery date she was admitted to hospital where the daily dialysis continued with the aid of Fresenius Medical Care acute staff. She was also given steroid treatment to allow the babies’ lungs to develop fully.

The now mother of four reports that her babies are doing well and have added a new – if initially unexpected – ray of light to her family.

Thank you Khadija and Lungisile for sharing your stories. We wish both you and your families all the best for the future!