Against the odds, kidney failure patient delivers a health baby

Dialysis couldn’t stop one woman's dream of motherhood

Growing up, Elizabeth Hill had her entire life planned. She would be her family’s first college graduate, a successful professional and, above all, a mother. “I always knew I was born to be a mom,” she says.

At 17, however, she was diagnosed with lupus, a disease that can attack almost any part of the body. “At first I fell into a deep depression,” the Yorba Linda resident explains. “But then I decided I was going to live a normal life.”

She did just that, earning her degree and later working as a human resources manager — a job she loved.

Hill was still living with lupus, though. By 2008, her kidneys were irreparably damaged by the disease. She received a kidney transplant, but it failed after just two years.

Seriously ill, Hill began dialysis treatments to cleanse her blood of the impurities normally eliminated by the kidneys. The treatments were lifesaving, but being on dialysis meant she would probably never have children.

“Dialysis patients rarely become pregnant,” says Dr. Carol Major, a UCI Health maternal-fetal medicine specialist. And if they do, they usually miscarry. 

This is because “a developing fetus is extremely vulnerable to metabolic changes that take place during dialysis,” explains Dr. Kamyar Kalantar-Zadeh, chief of the UCI School of Medicine's Division of Nephrology & Hypertension.

Then — against the odds — Hill learned she was pregnant. “I had a million emotions,” she says. “I’d been told this would never happen, but now it had.”

The 34-year-old Hill was immediately referred to UCI Health, one of the nation’s leading centers for treating kidney disease and managing high-risk pregnancies. UCI Health kidney and obstetric-gynecologic specialty services both have been ranked among the best in the country by U.S. News & World Report.

Hill’s treatment team included nephrologists as well as obstetricians with expertise in managing complex, high-risk pregnancies. “We coordinated her treatment across all specialties on a daily basis,” says Major, who cared for Elizabeth throughout her pregnancy.

“To better maintain the delicate balance so critical for mother and baby," says Kalantar, "Elizabeth underwent dialysis six times a week instead of the usual three.”

During dialysis, the fluid removed had to be carefully measured and analyzed to ensure that the developing fetus was still receiving enough fluid volume. And after each dialysis session, Hill underwent fetal heart rate monitoring for more than an hour to make sure the baby was doing well. On Sundays — the one day Hill didn’t make the trek to UC Irvine Medical Center — she and Major texted each other.

“Dr. Major and I have this amazing bond,” Hill explains. “She’s so incredibly wonderful and caring. I’ve never met a doctor like her.”

Even with the unprecedented care she received, Hill’s pregnancy was extremely difficult — jeopardized by anemia and a liver condition that caused intolerable itching.

“When Elizabeth developed liver problems, we called in our liver disease experts,” Kalantar says. “We tailored treatment to her unique needs, using all our expertise and resources to deal with each setback."

Hill braved all the complications, risks and discomfort, having faith that her baby would be healthy. Her determination paid off.

Baby Audrey was born in November 2012, just four weeks short of full-term. “It was the most unbelievable feeling in the world,” recalls Hill. “Dr. Major kept telling me, ‘We did it. She’s perfect.’”

Hill is back on dialysis three days a week, and mom and baby are thriving, thanks to Hill’s extraordinary strength and determination, her faith, her husband, Sean, and her UCI Health doctors.

“Elizabeth is an amazing woman and mother,” says Major. “She was told she would never get pregnant, yet she got the proper care and had a completely successful pregnancy. Her story is a source of hope for other women who are facing the same challenges.”

To learn more about kidney disease and dialysis services, visit ucirvinehealth.org/dialysis. For more information about high-risk pregnancy care, visit ucirvinehealth.org/high-risk or call 714-456-2911.

Hill's story appears in the winter 2013-2014 issue of UCI Health magazine.