Article informationBackground: Patients with chronic renal disease, particularly those on frequent hemodialysis, exhibit distinct mineral and endocrine changes. Extra-osseous bone formation promoters and inhibitors are out of balance, which results in vascular calcification, a dynamic process controlled by bone kidney disease. Aim of the work:To determine if hemodialysis patients' fetuin-A levels correlate with their risk of abdominal aortic calcification.Patients and Methods: Sixty Hemodialysis patients [30 cases and 30 controls] from Ain shams University Hospitals were enrolled in this comparative cross-sectional study. All the patients have signed an informed consent and underwent laboratory and radiological investigations, including a pelviabdominal x-ray examination. Multislice CT abdomen was done for the cases only.Results: In the group with aortic calcification, the mean serum fetuin-A concentration was 302.51±68.46 ng/ml [range: 201.3 -414.6 ng/ml], while in the group without aortic calcification, it was 564.53±135.55 ng/ml [range: 284.3 -793.2 ng/ml].Regarding the relation between fetuin-A and aortic calcium score, there was a non-significant negative correlation [p-value = 0.376] [r = -0.168] in the studied population. Conclusion:We found a statistically significant difference between the two groups in terms of serum fetuin-A levels. However, there was no significant association between fetuin-A and aortic calcium score. The duration of dialysis and Ca x P Product were the most critical two parameters affecting the fetuin-A level.

Background: About one-fifth of the adult population has end-stage renal disease (ESRD), which is associated with an elevated risk of illness and death. To remove excess sodium from the body, hemodialysis treatments using dialysate sodium (D-NA) with a concentration of 120 mEq/L have been utilized for decades. Higher D-Na (around140 mEq/L) has been employed for dialysis hemodynamic stability over time. Objective: To determine the impact of decreased dialysate Na (equal to or less than 135 mEq/L) on cardiac functions and different echocardiographic parameters in prevalent hemodialysis patients. Patients and Methods: At Rod Elfarag Hospital's Dialysis Unit, 45 patients on regular hemodialysis underwent a 6month prospective study. Results: This study found a significant difference between baseline and six-month lab results in terms of hemoglobin, WBCs, platelets and Ht/URR as well as serum albumin and Ca/Na/phosphorus and BNP (p < 0.001). We discovered a highly statistically significant variation in PR interval, QRS duration, and QT interval between the baseline and followup ECGs after six months (p < 0.001). There was high statistically significant difference between baseline echocardiography and after 6 months echocardiography as regard left atrium diameter, ejection fraction (EF%), diastolic blood pressure (DBP) and systolic BP (p < 0.001). Conclusion:Our results showed that the PR interval, QRS duration, and QT interval at baseline were all statistically significantly different from those after six months of treatment. DBP couldn't be lowered in this short time frame at all. This strategy's impact should be investigated in depth over an extended period of time.

Background: Worldwide, chronic kidney disease (CKD) is a major public health issue. The Global Burden of Disease study stated that, worldwide mortality attributed to renal failure showed a tremendous rise with around 1.2 million deaths from renal failure in 2015. Atherosclerosis, especially peripheral arterial disease (PAD), is more common in people undergoing hemodialysis (HD). However, there are some correlations that appear to be unique to dialysis patients when it comes to risk factors for peripheral artery disease. Objective: To study the relation between PAD assessed by ankle brachial index (ABI) and serum level of 25(OH) vitamin D among maintenance HD patients from multiple dialysis centers in Kafr El-Sheikh Governorate, Egypt. Patients and Methods: From the dialysis centers in Kafr El-Sheikh Governorate, Egypt, a total of 90 ESRD patients on maintenance HD were recruited for this study and were divided into two groups, 45 with PAD assessed by ABI (value less than 0.9) and 45 without PAD assessed by ABI (value more than or equal 0.9). Study was done over six months starting from April 2019 till end of October 2019. Results: Serum 25(OH) vitamin D levels differed statistically significantly between the two groups (P< 0.001). Patients and control groups both showed a statistically significant positive connection between ABI and their serum vitamin D level (P< 0.001). Conclusion: PAD is linked to vitamin D insufficiency in people who are on maintenance hemodialysis.

Background: Patients with chronic kidney disease (CKD) are susceptible to cardiovascular calcification because of a variety of factors. It is possible that magnesium (Mg) may play a role in the calcification of the arteries in several ways. Objectives: The goal of this research was to examine the relationship between serum magnesium level and vascular stiffness & valvular calcification in hemodialysis patients. Patients and methods: This prospective cross sectional case control study included a total of 100 prevalent hemodialysis patients who were maintained on thrice weekly hemodialysis sessions, attending at hemodialysis unit, Ain Shams university Hospitals. The included subjects were divided into two groups; Group I: consisted of 68 individuals with normal Mg levels, while group II: contained 32 patients with low Mg levels. Results: No statistically significant differences were found as regards the laboratory and radiological investigations between both groups apart from hemoglobin (Hb) result. Mg level was positively correlated with Hb level. Conclusion: It could be concluded that there is high prevalence of cardiovascular calcification among hemodialysis patients that may be related to age but without a statistically significant correlation to Mg level. Cardiac functions decrease with the progression of atherosclerosis and arterial stiffness.

Background Chronic kidney disease (CKD) is a major public health problem worldwide and is associated with a considerable increase in morbidity and mortality, cardiovascular disease is most common cause of death among chronic kidney disease patients. There is an increasing interest in using vitamin D levels as a novel marker for CVD, because epidemiological data have shown a strong correlation between the risk of CVD and vitamin D deficiency. Objectives The aim of study was to determine the association between serum vitamin D level and cardiac functions assessed by tissue Doppler imaging in chronic kidney disease patients. Patients and Methods Our study conducted on 90 patients from outpatient clinic or inpatient department of national institute of nephrology and urology. All patients were subjected to full history, full clinical examination, laboratory investigations including: serum urea, serum albumin, complete blood picture, serum electrolytes (calcium and phosphorus), PTH, serum vitamin D, lipid profile and echocardiography and Tissue Doppler imaging. Conclusion Serum vitamin D is positively correlated with diastolic function among CKD patients, increased incidence of left ventricular hypertrophy in CKD patients especially with vitamin D deficiency, Tissue Doppler imaging is more accurate than echocardiography to estimate diastolic function.