Successful full-term delivery in a patient with maintenance hemodialysis using natriuretic peptides as volume markers without X-ray examination: a case report and literature review

A 38-year-old female undergoing maintenance hemodialysis became pregnant. To avoid X-ray exposure, plasma levels of natriuretic peptides were mainly used to determine dry weight. Dry weight was increased every week according to the gestation week. By closely monitoring the levels of natriuretic peptides, blood pressure, and amniotic fluid volume, general conditions remained stable. At 37 weeks of gestation, she delivered a healthy girl with an appropriate-for-date birth weight. We propose the measurement of natriuretic peptides as useful for managing volume during pregnancy without X-ray exposure. Future studies are required to explore the regulation and monitoring of hydration status during pregnancy. Hemodialysis Pregnancy Dry weight Natriuretic peptide X-ray