Perspectives on Pregnancy in Women With CKD: A Semistructured Interview Study

摘要: Background Women with chronic kidney disease (CKD) often have difficulty achieving pregnancy and are at increased risk for adverse outcomes. Given the medical, ethical, emotional complexities of in CKD, clinical approach should involve explicit consideration women's values, which there sparse data. This study aims to describe beliefs, experiences women CKD inform prepregnancy counseling care. Study Design Qualitative study. Setting & Participants 41 (95% response rate) aged 22 56 years stages 3 5 (n=5), receiving dialysis or received a transplant (n=31) from 2 renal units Australia. Methodology Semistructured interviews. Analytical Approach Transcripts were analyzed thematically. Results 6 themes identified: bodily failure (conscious fragility, noxious self, critical timing, suspended limbo), devastating loss (denied motherhood, disempowered by medical catastrophizing, resolving grief, barriers parenthood alternatives, social jealousy), intransigent guilt (disappointing partners, fear genetic transmission, respecting donor sacrifice, judgment), rationalizing consequential risks (choosing survival, avoiding fetal harm, responding family protectiveness, compromising health, decisional ownership, unjustifiable gamble), strengthening resolve (hope opportunity, assurance, resolute determination, reticent hope), reorientating focus (valuing life gratitude hindsight). Limitations Only English-speaking recruited, may limit transferability findings. Conclusions Decisions surrounding context require confront uncertainties about their own progression, toward donor, outcomes offspring, transmission. Communicating must be carefully balanced values autonomy, hope, security, family. Informed shared decision making that addresses priorities as identified this help contribute improved pregnancy, psychosocial vulnerable population.