Eficacia de las diferentes terapias de sustitución renal en pacientes gestantes. Revisión Sistemática

Abstract

Background: During pregnancy, increased physiological demands may exacerbate complications associated with pre-existing or gestational kidney disease. Renal replacement therapies, such as hemodialysis and peritoneal dialysis, are essential for the treatment of kidney disease in pregnant patients. The effectiveness of these therapies lies in their ability to remove waste products and maintain electrolyte balance, thus contributing to maternal and fetal health. Methods: A systematic review of articles in English and Spanish published between 2019 and 2024 was conducted. Search terms and Boolean operators were applied in databases such as PubMed, Redalyc, and UpToDate. Data were organized using a search matrix in Excel and a bibliographic manager in Zotero, the analyzed articles were compiled in a folder. Results: This review examined various types of treatments for kidney disease in pregnant patients. These treatments include conventional hemodialysis, extended hemodialysis, automated peritoneal dialysis, continuous ambulatory peritoneal dialysis, and hemodiafiltration. The outcomes for both mother and fetus were analyzed for each treatment, and the advantages and disadvantages of each modality in each therapy were explained. The aim was to understand the effectiveness of these treatments. Conclusion: Hemodiafiltration is the most effective renal replacement therapy, as it plays a fundamental role in the efficient removal of uremic toxins in pregnant women and is also considered an innovative technique with a lower risk of fetal complications. Keywords: dialysis, pregnancy, replacement