Under what circumstances would you initiate hemodialysis for fetal protection in a pregnant patient with CKD Stage 4 who does not have any usual indications to start dialysis?  

There is no generally accepted criteria for starting dialysis in pregnant women, and not much literature on the subject.  Having said that, GFR <30, sCr >2, BUN>50, or metabolic acidosis are some of the criteria used. Subjects with lower GFR, proteinuria, and hypertension are at h...