This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/pd.5639 Pregnancy on dialysis and with a failing kidney graft: a double challenge for non-invasive prenatal testing Rossella ATTINI 1 , Francesca Romana GRATI 2 , Guido MENATO 1 , Tullia TODROS 1 , Loredana COLLA 3 , Maura ROSSETTI 3 , Barbara MALVESTITI 2 , Maria Grazia ALEMANNO 1 , Bianca MASTURZO 1 , Giorgina Barbara PICCOLI 4-5 , Elsa VIORA 1 1. Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza- Sant'Anna Hospital, Torino, Italy. 2. Research and Development, Cytogenetics and Medical Genetics Unit, TOMA Advanced Biomedical Assays, Impact lab Group, Busto Arsizio (Varese), Italy. 3. SCDU Nephrology, Department Città della Salute e della Scienza, University of Torino, Torino, Italy. 4. Service de Nephrologie, Centre Hospitalier Le Mans, Le Mans, France. 5. Department of Clinical and Biological Sciences, University of Torino, Torino, Italy. Pregnancy in women with chronic kidney diseases (CKD) is increasingly being encountered in obstetric practice: it is estimated that about 3% of women of childbearing age have initial CKD, while the estimate of the prevalence of advanced CKD is between 1:150-1:750 women. Fertility is reduced, in particular in advanced CKD. However, pregnancies during dialysis and after kidney transplantation are increasingly being reported 1 . The increase in reports of pregnancy during dialysis is probably due to the fact that intensive dialysis (daily dialysis, up to 8 hours per day) has significantly improved pregnancy outcomes, increasing both the live birth rate (presently over 80% in the intensive-dialysis series) and duration of gestation (about 36 weeks, in the same series) 2 . Kidney transplantation (KT) partially restores fertility in women with end-stage kidney disease; however, the pregnancy rate is lower than in the general population and it is estimated that This article is protected by copyright. All rights reserved.