Case report: Applicability of breastfeeding the child of a patient with kidney failure with replacement therapy

Frontiers in Medicine

Medicine

Anastasia E. Filat’eva¹  Elena V. Kondakova¹  Maria V. Vedunova¹  Nadezhda A. Lobanova²  Sergey V. Gudkov³  Egor I. Nagaev³  Ruslan M. Sarimov³ 

[1] Institute of Biology and Biomedicine, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia;Institute of Biology and Biomedicine, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia;Branch FESFARM NN, Nizhny Novgorod, Russia;Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia;

关键词: case report;    breastfeeding;    immunology;    Kidney Failure with Replacement Therapy (KFRT);    biochemistry;    molecular physics;   

DOI  :  10.3389/fmed.2023.1098324

 received in 2022-11-14, accepted in 2023-01-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

This case report highlights the benefit or harm of breastfeeding in a patient with Kidney Failure with Replacement Therapy (KFRT) undergoing program hemodialysis. This is a unique clinical case, as pregnancy and successful delivery are rare in this group of females. With a favorable outcome, the possibility of breastfeeding is especially relevant for doctors and the mother. The patient was a 31-year-old female who was diagnosed in 2017 with end-stage renal disease associated with chronic glomerulonephritis. Against the background of hemodialysis, pregnancy, accompanied by polyhydramnios, anemia, and secondary arterial hypertension, occurred in 2021. At 37 weeks, a healthy, full-term baby girl was born, and breastfeeding was started. In this study, we conducted a detailed analysis of toxic substances and immunologically significant proteins using high-tech analysis methods. In addition, we studied different portions of milk before and after hemodialysis at different time intervals. After a wide range of experiments, our study did not reveal an optimal time interval for breastfeeding a baby. Despite the decrease in the level of the major uremic toxins 4 h after the hemodialysis procedure, their level remained high. In addition, the content of nutrients did not reach acceptable limits and the immune status was characterized as pro-inflammatory. In our opinion, breastfeeding is not advisable for this group of patients since the concentration of nutrients is low, and the content of toxic substances exceeds the permissible limits. In this clinical case, the patient decided to stop breastfeeding one month after delivery due to insufficient breast milk and the inability to express it in a certain period of time.

【 授权许可】

Unknown   
Copyright © 2023 Kondakova, Filat’eva, Lobanova, Nagaev, Sarimov, Gudkov and Vedunova.