الفهرس 
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Abstract
Chronic kidney disease (CKD) is a worldwide public health problem and is now recognized as a common condition that is associated with increased risk of cardiovascular diseases and chronic renal failure.
Cardiovascular disease is the leading cause of mortality and morbidity in patients with chronic kidney disease. Recent clinical studies have shown that higher serum osteoprotogerin levels are associated with vascular calcification and cardiovascular mortality among patients with end stage renal disease.
Vascular calcification is influenced by derangements of calcium and phosphate homeostasis, including deregulation calcification inhibitors and promoters, and different type of underlying arterial diseases e.g. atherosclerosis vs. arteriosclerosis.
Osteoprotogerin act as a decay receptor for receptor activator of nuclear factor B. This plays an important regulatory role in the skeletal, immune and vascular systems. Accumulations of osteoprotogerin results in early onset severe osteoporosis as well as significant medical calcification of the aorta and renal arteries.
Recent developments in methods to monitor OPG level have provided an improved understanding of its role in various diseases, particularly in cardiovascular diseases. Elevated osteoprotogerin is described as the missing link between multiple cardiovascular risk factors and the development of vascular calcification and hence arterial stiffness.
In this study, we tried to assess the relationship between serum osteoprotogerin and the risk of cardiovascular disease (arterial stiffness) in the patients with chronic kidney disease.
This study included 100 subjects, divided into 3 groups, 20 patients (11 male, 9 female) as normal subjects, 40 patients (29 male, 11 female) as CKD on conservative therapy and the other 40 patients with ESRD (25 male, 15 female) on regular hemodialysis therapy.
All the studied groups were subjected to the following:-
1. Clinical examination:
Through history taking and complete clinical examination.
2. Laboratory investigations:
A. Routine investigations:
-Complete blood count (CBC).
-Kidney function test (urea, creatinine).-
-Estimated GFR(by cockcroft- gault formula).
-Serum calcium level.
-Serum phosphorus level.
-Serum albumen.
-Alkaline phosphatase level.
-Intact parathyroid hormone level.
B.Special investigation:
-Serum osteoprotogerin measured by ELISA.
-Carotid intima media thickness, measured through Ultrasonographic examination of carotid artery using a 5 to 10 MHz transducer. This done for common carotid arteries.