Dialysis may be needed, either acutely or on a chronic basis, during pregnancy for a variety of reasons. Advances in erythropoietin, transplant, and hormonal therapies may increase the chances of pregnancy in women with chronic renal failure. Providing care to this population of patients is a challenge to nephrology and obstetric nurses. It is important for the obstetric nurse to understand the fundamental principles of dialysis to collaborate in the planning and implementation of care for these patients.