Background: Secondary carnitine deficiency may develop in chronic renal failure (CRF) patients undergoing longterm hemodialysis (HD), with a resulting higher incidence of cardiovascular diseases, dyslipidemia and oxidative stress. We studied the efficacy of 12 months of L-carnitine supplementation on the amelioration of dyslipidemia, oxidative stress and cardiac dysfunction in 24 CRF children undergoing long-term HD compared with 24 age-and sex-matched controls. Methods: Plasma samples were analyzed spectrophotometerically before and after dialysis sessions and after 2-month supplementation with oral L-carnitine (50 mg/kg/day) for free carnitine (FC), the lipid profile, and oxidative stress markers. Echocardiography the day following dialysis measured cardiac diameters, wall thicknesses, left ventricular mass index (Ml), end diastole and systole volume indices and functions. Results: The pre-dialysis FC concentration was substantially lower than controls and decreased significantly at the end of the dialysis session. Pre-and post-dialysis plasma levels of free fatty acids (FFAs), trigyleride (TG), total cholesterol (TC) and oxidative stress markers significantly increased while high-density lipoprotein cholesterol (HDL-C) and phospholipids significantly decreased compared to controls. Echocardiography detected a significant increase in cardiac diameters and thickness, and systolic and diastolic cardiac dysfunction. After L-carnitine supplementation, plasma levels of FC increased to normal levels. FFAs, TC and HDL-C returned to control levels while TG, phospholipids, and the oxidative stress markers decreased but remained significantly higher than controls. There was a significant decrease in cardiac diameters and an increase in left ventricular diastolic function (E/A ratio), but no correlation between FC levels and echocardiographic parameters. Pre-dialysis, post-dialysis and after treatment, plasma FC level showed a significant positive correlation with HDL-C and phospholipids and a significant negative correlation with each of oxidative stress markers, FFAs, TG and TC. On the other hand, FFAs showed a significant positive correlation with TG, TC, DC, NO and a significant negative correlation with HDL-C and phospholipids. Conclusion: This study demonstrates that CRF children under regular HD suffer from a decrease in the level of plasma FC, dyslipidemia, oxidative stress, and an increase in cardiac diameters and thickness with impairment of cardiac functions. Oral L-carnitine supplementation at a dose of 50 mg/kg for 2 months can increase plasma FC level, improve dyslipidemia, decrease oxidative stress with reduction of cardiac diameters and increase in diastolic function.

Chronic kidney disease (CKD) is recognized as a major health problem affecting approximately 13% of the US population. Nutritional status and academic achievement were affected in 1.3% of Egyptian school age children with urinary abnormalities. Aim: to assess nutritional status and academic achievement among school-age children with chronic kidney disease at Assiut University Children Hospital. Subjects and Method: The study sample was composed of 102 school-age children with CKD. The study was conducted in the Pediatric Nephrology Unit and Outpatient Clinics at Assiut University Children Hospital. Data were collected by utilizing the designed questionnaire sheet that consists of sociodemographic data, socioeconomic data, children's anthropometric measurement as well as assessment of their academic achievement. Results: The results of study revealed that the percentage of anthropometric school-age children under study was normal or around average with no statistical significant between CKD and nutritional status. Regarding academic achievement, about one third of the studied children with CKD had pass average academic achievement score. Conclusions: Based on the results of the present study, chronic kidney disease did not affect nutritional status, but it negatively affected academic achievement in school-age children at

This paper highlighted a set of issues facing the residential house system and makes it unsustainable systems including: high energy consumption, high water demand, waste generation, and carbon dioxide emissions. The boundaries, inputs and outputs of residential house systems are displayed in detail and illustrated by modeling these systems for the purpose of understanding the relationships and interactions between these inputs and outputs and components of these systems. Thus, presenting a range of strategies that can be implemented to make residential house systems more sustainable and reduce the negative impacts of these systems on the environment and other sources such as water, energy and non-renewable resources to a minimum level.