Aim and objective: To analyze five patients with chronic kidney disease (CKD) with pregnancy managed with hemodialysis for better maternal and fetal outcomes. Design: Original article. Setting: A hospital-based prospective study. Patients: Five women with CKD reported in second trimester of pregnancy. Interventions: Hemodialysis done in all antenatal patients. Main outcome measures: Analyze maternal and fetal outcomes in patients with CKD treated with hemodialysis during pregnancy. Using hemodialysis to prolong the pregnancy by preventing preterm delivery. Results: Out of five patients, three patients had live fetuses and two patients’ fetuses had intrauterine growth retardation and low birth weight babies. Pregnancy was prolonged to 9 weeks in two patients, 4 weeks in two patients, and 21 days in the fifth patient. Conclusions: Possible return of fertility to the dialysis patient and pregnancy is most often unexpected. Hemodialysis to be considered for better maternal and fetal outcomes. Hemoglobin, electrolyte, nutrition, and proper weight gain to be monitored. Careful monitoring of the patient to avoid intradialytic hypotension is important. The close collaboration and motivation of the different medical and paramedical staff also depend on the outcome of the pregnancy. It is strongly advised to the dialyzed woman to wait for having been transplanted successfully to plan a pregnancy.