Elizabeth Wong
Elizabeth Wong, a nurse in the Home Hemodialysis unit at UHN, holds a family photo from Bella Aggarwal, a patient who delivered three healthy boys while managing a chronic kidney disease. Her youngest two were born while Bella was on hemodialysis. (Photo: UHN)

Bella Aggarwal always dreamed of having a family of her own.

But when she found out she was pregnant for the first time in 2003, she remembers initially feeling an unshakable fear instead of joy.

She knew her pregnancy would be made complicated due to her chronic kidney disease. Bella was diagnosed with IgA nephropathy at age 11, which would, over time, significantly hamper her kidneys' ability to filter wastes from her blood.

Bella delivered a healthy baby boy at the Special Pregnancy program at Mount Sinai Hospital in 2003, but the health of her kidneys continued to decline rapidly over the next six years.

To learn more about World Kidney Day, which is being marked today, visit the booth in the Eaton Lobby at Toronto General from 8 a.m. – 2 p.m. for information and prizes. Click here for more information.

Bella and Kapil Aggarwal's first child, Ajay
Bella and Kapil Aggarwal's first child, Ajay, is now 14 years old. Bella's health quickly declined after his birth, and ultimately led to kidney failure. (Photo courtesy of Bella Aggarwal)

"It was like wildfire," Bella, now 42, says. "The big unknown was the scariest part – not knowing what would happen next and how I would survive."

In 2009, she was told by her healthcare team at UHN she would have to start hemodialysis. It's a process that cleans the blood and is typically needed at end-stage kidney failure. After three unsuccessful surgical procedures to insert a line to her kidneys to facilitate the dialysis, she finally had a successful line inserted from her collarbone.

Bella says she remembers feeling exhausted and scared.

In her mind, having more children was out of the question. Doctors agreed.

"They told me I was likely infertile because I've gone through so many drugs and had so many treatments," she says. "I wanted my family to grow, but I gave up on it."

Then, it happened. Twice.

Bella found out she was pregnant in 2009, then again in 2011.

"When I found out I was pregnant, a light switch went on and it gave me the strength I needed to push through," she says.

"I had to do it – like breathing."

Bella children
While on hemodialysis, Bella delivered two healthy babies, Nikhil (R) and Dhilan, seen here being held by their older brother, Ajay. Years prior, her doctors told her she was likely infertile due to her chronic kidney disease. (Photo courtesy of Bella Aggarwal)

Bella was dialyzing at home for about 40 hours per week – a threefold increase on the average person on hemodialysis, according to Dr. Christopher Chan, Bella's nephrologist and Director of Nephrology at UHN.

"She knew she wanted to have more than one child, so we did everything we could to support her," says Dr. Chan.

Dr. Chan says UHN has among the most experience in the world working with women who deliver babies while undergoing home hemodialysis – about 30 to date in the Greater Toronto Area.

"I kept telling her that it's okay to take one day off," says Elizabeth Wong, Bella's nurse of five years in the Home Hemodialysis unit. "She kept going because she wanted to have her body as clean as possible for her baby.

"She's a loving mother."

Another light at the end of the tunnel

Just when Bella and her family thought they already had so much to be grateful for – three healthy, beautiful boys – along came another surprise.

Bella's younger brother, Amit, was found to be a perfect match to be a living kidney donor for her. In August 2014, the transplant was a success.

"My brother is everything to me, and he gave everything to me," Bella says.

Today, Bella and Amit both live healthy lives with their families in the Greater Toronto Area. Though maintaining her good health is a lifelong journey, Bella was able to return to full-time work six months after her transplant.

Bella and brother
Bella and Amit are 10 years apart. Amit gave his kidney to Bella in 2014, allowing her to return to work full-time and (Photo courtesy of Bella Aggarwal)

World Kidney Day 2018 addresses women's health

Chronic kidney disease is a worldwide public health problem, affecting about 195 million women worldwide. It is the eighth leading cause of death in women with almost 600,000 deaths each year, according to a report by the Global Burden of Disease.

The campaign for this year's World Kidney Day, which is being marked today, puts women's health at the forefront, pushing for more awareness of kidney disease, timely diagnosis and proper follow up in pregnancy.

Bella says she hopes her story can give strength and positivity to women who may be going through a similar health journey.

"The unknown is the biggest fear," she says. "But positivity is honestly what keeps people going."

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