{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T17:05:28Z","timestamp":1765559128603,"version":"3.48.0"},"reference-count":16,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Nephrol Dial"],"abstract":"<jats:p>Introduction: Managing pregnancy in patients with end-stage kidney disease (ESKD) undergoing dialysis is challenging, with hypoalbuminemia significantly increasing risks to both maternal and neonatal outcomes. Intensive hemodialysis regimens are recommended; however, individualized and adaptive dialysis strategies, such as sequential online hemodiafiltration (OL-HDF) and intermittent HDF (i-HDF), may be required to optimize care in complex cases. Case Presentation: We report the case of a 27-year-old Japanese woman with ESKD who transitioned from OL-HDF to i-HDF during pregnancy due to progressive hypoalbuminemia at 30 + 5 weeks of gestation. Dry weight adjustments were guided by human atrial natriuretic peptide (hANP) levels, blood pressure measurements, and bioimpedance analysis. i-HDF reduced albumin loss compared to OL-HDF, stabilized maternal hemodynamics, and enabled term delivery at 39 + 1 weeks with a healthy neonate weighing 2,774 g. Bioimpedance analysis and hANP-guided adjustments allowed for precise fluid management, resulting in a total gestational weight gain of 6.4 kg. The patient developed superimposed preeclampsia during labor, which was successfully managed. Conclusion: This case demonstrates that sequential OL-HDF and i-HDF can effectively address hypoalbuminemia and fluid imbalances, contributing to successful maternal and neonatal outcomes in ESKD pregnancies.<\/jats:p>","DOI":"10.1159\/000549586","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T17:01:24Z","timestamp":1763398884000},"page":"278-285","source":"Crossref","is-referenced-by-count":0,"title":["Adaptive Hemodiafiltration Strategies in a Full-Term Pregnancy with End-Stage Kidney Disease: A Case Report"],"prefix":"10.1159","volume":"15","author":[{"given":"Masato","family":"Sakai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4141-1933","authenticated-orcid":false,"given":"Erika","family":"Hishida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Ogura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Ogoyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshimi","family":"Imai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsu","family":"Akimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Satonaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironori","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8888-9937","authenticated-orcid":false,"given":"Hiroyuki","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Nagata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2011.00996.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfv016"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfac204"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2020.06.001"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-020-01226-4"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-020-02489-9"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003334"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-019-0550-6"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-196507000-00004"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.207"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1159\/000528725"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1177\/147323001103900643"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2018.197"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.48"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-021-01146-3"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1159\/000503891"}],"container-title":["Case Reports in Nephrology and Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000549586","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T17:01:06Z","timestamp":1765558866000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000549586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,14]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000549586","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.30618878","asserted-by":"subject"}]},"ISSN":["2296-9705"],"issn-type":[{"type":"electronic","value":"2296-9705"}],"subject":[],"published":{"date-parts":[[2025,11,14]]}}}