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

Pregnancy, insulin-dependent diabetes mellitus, and end-stage renal disease requiring dialytic therapy each demand specialized nutritional intervention. When all three occur simultaneously, assessment of needs and monitoring for adequacy become complex. Detailed nutritional information is lacking for this combination, forcing practitioners to glean recommendations and potential concerns from literature addressing each individual diagnosis. Glycemic control, appropriate micronutrient supplementation, and consistently meeting calorie and protein needs may reduce likelihood of an adverse pregnancy outcome.