الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
End stage renal disease (ESRD) is one of the most common life-threatening diseases. The number of patients accepted for renal replacement therapy including hemodialysis (HD), peritoneal dialysis, and kidney transplantation in developed and developing countries is increasing every year and imposes a major social and economic burden on these communities. The etiology of renal failure, the presence of comorbid disease and the method of renal replacement therapy and its adequacy are important factors that affect the survival of ESRD patients. Hemodialysis constitutes the most common form of renal replacement therapy (RRT) worldwide. The goal of dialysis in patients with ESRD is to restore the body’s extracellular and intracellular composition to that of normal to the greatest extent possible, and the surrogate marker for this physiological achievement of dialysis in clinical practice has relied on the measurement of adequacy of dialysis. Secondary hyperparathyroidism is a common complication in CKD and hemodialysis patients. It can be ascribed by hyperphosphatemia, hypocalcaemia, deficiency of 1,25(OH)2 vitamin D, skeletal resistance to vitamin D, and reduced expression of calcium sensing receptors. It may be considered that this study is one among few other studies which were designed to evaluate the direct relation between the parathyroid hormone and AVF of hemodialysis patients, and its impact on dialysis efficiency. This observational prospective study was carried out on 50 patients attending the Nephrology and dialysis Unit at Mansoura university hospital (MUH), who had been on hemodialysis for more than one year utilizing AV fistulas. Patients with complicated AV fistulas by trauma, infection or inappropriate surgical procedure were excluded from the study. All participants were subjected to thorough history taking and clinical examination as well as laboratory tests including, among others, the intact parathyroid hormone (iPTH) were performed both at the start and at the end of one year follow-up. Physical examination of AV fistula including the glucose pump test (GPT), as well as Duplex ultrasound of the AVFs and the right common carotid artery were performed at the start and at the end of the study.