Nutritional management of pregnancy in a chronic hemodialysis patient with insulin-dependent diabetes mellitus

Medical nutrition therapy in pregnancy and kidney disease

Pregnancy in the face of kidney disease poses a new dimension to medical nutrition therapy. Individualization for specific nutrient needs is paramount, whether the patient has renal insufficiency, requires hemodialysis or peritoneal dialysis, or has a renal transplant. Practice guidelines for pregnancy and kidney disease were first developed in 1986 and revised in 1992. These guidelines provided the foundation for present nutritional management of pregnant women with kidney disease. Based on the most current research and clinical case reviews, the following is a revision of these guidelines, incorporating medical nutrition therapy protocols and outcome parameters to improve assessing, tracking, and monitoring patient care in this unique population.