LHSC helps women with kidney failure deliver healthy babies while on dialysis

Exceptional Experiences

April 4 , 2012

Kim Barrey holds one-year-old son Evin at a clinic visit with RN Rosemary Leitch and nephrologist Dr. Robert Lindsay.
Kim Barrey holds one-year-old son Evin at a clinic visit with RN Rosemary Leitch and nephrologist Dr. Robert Lindsay.

(LONDON, Ontario) – Ten years ago when she was 27 years old, Kim Barrey was told she was in kidney failure and immediately began routine dialysis treatment through London Health Sciences Centre’s Regional Renal Program. In addition to the life-altering kidney failure diagnosis, Barrey was also told she was unlikely to ever get pregnant, and was not advised to try as it could jeopardize her fragile health.

“I remember I just sat there and cried,” recalls Barrey, now 36. “It was heartbreaking and overwhelming and just so much stress.” A few years later and in much better health thanks to regular dialysis treatments, Barrey was further overwhelmed when, during routine pre-op tests for her second kidney transplant surgery, she discovered she was pregnant.

“I knew that the transplant would change my life, and I wanted that kidney. But I wanted a baby a lot more, and from that point I knew that my life was going to be so much more amazing because of him,” says Barrey from her home in Woodstock, Ont. where last Friday, March 30, Barrey’s “little miracle boy” Evin celebrated his first birthday.

Dialysis is the process of removing toxins and fluids from the body through a machine, a process normally controlled by the kidneys (or renal system). Traditional hospital dialysis means patients come in three times a week for three- to-four hours per session. Other methods include peritoneal dialysis, which is when a patient has a permanent tube in the abdomen that is used to flush away toxins while he or she sleeps, and home hemodialysis that can also be performed overnight. LHSC’s Regional Renal Program offers all of these dialysis options for patients.

In 2008, under the supervision of her nephrologist Dr. Robert Lindsay, Barrey was enrolled in a clinical trial that put her on more frequent, six-days-a-week dialysis. This consistent and more frequent dialysis — compared to traditional three times a week— helps to further stabilize and improve patients’ health. In 2009 Barrey began nocturnal home hemodialysis which provides dialysis treatment seven hours a night, for five nights a week.

“The more you dialyse, the better you will feel because your body is able to clear more toxins, meaning you increase your ‘clearance’ levels,” says Rosemary Leitch, a primary care nurse in LHSC’s renal program. “With better clearances, in some cases our female patients’ menstrual cycles actually start back up, so they are able to get pregnant.”

However, even if a female patient is able to conceive, it’s a very high-risk pregnancy as the kidneys are expected to work even harder throughout a pregnancy; an option not available when a patient is already on dialysis.

Barrey is only the second successful patient (and third pregnancy) at LHSC’s Regional Renal Program to get pregnant while on dialysis, and Leitch worked with her colleagues to provide additional care and attention for Barrey throughout her pregnancy.

“Being pregnant while in kidney failure means dialysis treatment every single day, and a lot of changes to medications,” says Leitch. “Intensive dialysis is required to get and stay pregnant, and you really need an invested team, from doctors to nurses to pharmacists, to ensure a happy and healthy outcome.”

Seven weeks before her delivery date, Barrey was admitted to the antenatal unit at St. Joseph’s Hospital (which transferred from St. Joseph’s to LHSC in June 2011). Rather than shuttle her back-and-forth from St. Joseph’s to the Adam Linton Dialysis Unit at LHSC’s Victoria Hospital, Leitch and her colleagues would visit Barrey’s hospital room every day to provide the life-saving dialysis that she and her unborn son required.

Now celebrating her son’s first birthday, Barrey has just completed the testing to be put back on the kidney transplant waiting list.

“I am so happy, and so in love with my family. A transplant would be nice, but I’m not pushing it,” says Barrey. “I’m very content where I am.”