Woman on Dialysis Defies Odds to Become Mother

When Tendai Chisambara was informed she required dialysis for her chronic kidney disease, she was also advised that conceiving a child during treatment would be practically impossible. A recent study indicated that between 2008 and 2014, only 584 women globally successfully gave birth while undergoing dialysis. Despite these significant odds, in 2023, Ms. Chisambara received the unexpected news of her pregnancy, and in January, she gave birth to her son, Zane. Tendai Chisambara, 36, arrived in Sheffield from Zimbabwe with her family at age 14. She was diagnosed with kidney failure at 20 while studying at a university in Bradford. She recounted, “My feet would be really swollen after uni. I used to elevate them but they weren’t getting better so my parents persuaded me to go to the hospital.” Doctors in Sheffield informed her that her kidney function was slowly deteriorating and that she would require medication, dialysis, and ultimately a transplant. She was also advised that “putting another body in my body would mean my kidney would be under too much strain”. During pregnancy, healthy kidneys must work overtime to keep the blood clean as the baby releases wastes into the mother’s bloodstream. For women whose kidneys are not functioning properly, pregnancy places even greater strain on the body, and more frequent dialysis is recommended to maintain the blood as clean as possible. While Ms. Chisambara stated she initially managed to come to terms with the dual challenges, she noted it became increasingly difficult over time. She explained, “When my boyfriend became my husband we managed it together. I was on medication and we got used to the routine. But then all our friends started having babies and I was going to lots of baby showers.” She mentioned that she and her husband, Crispen, had begun exploring surrogacy when, unexpectedly, she became pregnant. She recalled, “I didn’t believe it. It couldn’t be real. I showed my husband the test. We bought four more pregnancy tests to make sure.” Throughout her pregnancy, she received frequent monitoring from multiple healthcare teams at Sheffield Teaching Hospitals NHS Foundation Trust, including an obstetrician, midwife, kidney doctor, dialysis nurse, and kidney dietician. She had to attend the hospital three times a week during the pregnancy for dialysis, and her baby’s progress was continually monitored through frequent ultrasound scans to identify and treat problems early. Dr. Veena Reddy, Consultant Nephrologist, stated: “Successful pregnancies in women on dialysis are extremely rare. The level of care and coordination between several specialist teams including the renal team, dieticians, anaesthetists and the maternal medicine team at Jessop Wing has been phenomenal.” Shortly after Zane’s birth in January, another development occurred in Ms. Chisambara’s journey. A kidney donor was located, and she was identified for a transplant. However, she made the difficult decision to decline the offer, explaining her desire to prioritize her son’s care. She explained her reasoning: “If I had the transplant I would have had to give up holding my baby. I wouldn’t be able to breast feed him. I couldn’t do that.” Having decided to decline the transplant, Ms. Chisambara is now back on the waiting list. She no longer needs weekly dialysis but continues to take medication for her condition. However, she affirmed that becoming a mother made all the challenges worthwhile, remarking: “He is incredible. He smiles at everyone. He must know he is a miracle.”