الفهرس 
PreeclampsiaOnly 14 pages are availabe for public view
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Abstract
Preeclampsia remains a major cause of maternal and fetal morbidity and mortality in Egypt and the world. Approximately 1 in 20 pregnancies is complicated by this disorder. Although there are many systemic manifestations of preeclampsia, its clinical hallmarks of hypertension, edema, and proteinuria reflect significant kidney dysfunction.
There are profound changes in renal function in normal pregnancy, which lead to marked alterations from the non-pregnant physiologic norms. Pregnancy-related Acute Renal Failure (ARF) may comprise up to 25% of the referrals to dialysis centers in developing countries and is associated with substantial maternal and fetal mortality.
In the presence of AKI complications such as hypervolemia eg, acute pulmonary edema or large cumulative positive fluid balance, hyperkalemia, metabolic acidosis (pH less than 7.1) and uremic symptoms (persistent nausea and vomiting, pericarditis, neuropathy, or an otherwise unexplained decline in mental status) dialysis should be considered as a mainstay therapy.
The international guideline group, Kidney Disease: Improving Global Outcomes (KDIGO) has brought together international experts from many different specialties to produce a definition and staging system that harmonizes the previous definitions and staging systems proposed by both The Acute Dialysis Quality Initiative (ADQI) and the Acute Kidney Injury Network (AKIN).
The main considerations when starting a patient with AKI on dialysis are the following: 1) timing of initiation of dialysis, 2) the modality of dialysis, and 3) dose of dialysis.
This research studied the effect of the application of early RRT (group E, 25 patients) in comparison to late RRT (group L, 25 patients) on length of ICU stay, weaning from dialysis in a 90 day follow up and outcome of parturient and neonate, in preeclamptic patients suffering from AKI according to changes in serum creatinine.
All patients were continuously monitored for vital signs, laboratory work and arterial blood gases.
Results showed reduction in ICU and and increase in number of patients weaned from dialysis in 90 day period.
from the results, it was concluded that application of early RRT using intermittent hemodialysis (IHD) was more effective in improving outcome of preeclamptic patients with AKI. There is a positive correlation between early dialysis and higher incidence of RRT independence which led us to focus on early application of RRT for better outcome.