الفهرس 
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Abstract
Chronic kidney disease is a global public health problem with a rising prevalence. Cardiovascular disease (CVD) is very common in patients with chronic kidney disease (CKD) and is by far the leading cause of morbidity and mortality in dialysis patients.
This study was conducted on fifty subjects, forty of whom were known adult ESRD patients on MHD for more than three months (Dialysis group) in Hemodialysis Unit of Internal Medicine department in – Menoufyia University Hospital, EGYPT. And ten healthy volunteers (control group).
The following patients were excluded from the study:
Patients with valvular heart disease.
Congenital heart disease
Ischemic heart disease
Patients with decompensated heart failure.
Patients with decompensate liver cirrhosis.
Patients with ascitis.
chronic obstructive airway diseases.
All participants were thoroughly interrogated and examined clinically and were subjected to complete blood count, kidney function tests and serum electrolytes, lipid profile ,serum albumin, FBS, PPBS, iPTH, 12 leads ECG, assessment of adequacy of HD based on Kt/V and transthoracic echocardiography
According to the echocardiographic examination results the dialysis group was divided into G1 included 30 patients (75%) with
Summary & Conclusion
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echocardiographic changes and G2 included 10 patients (25%) without any echocardiographic changes.
Results of the study demonstrated that Body weight, was significantly lower in patient groups compared to control group, while Systolic BP, diastolic BP and Mean arterial BP were significantly higher in dialysis patients compared to control group with increased prevalence of hypertension in G1.
Hemoglobin levels and platelets count were lower in ESRD patients on MHD, the lipid profile showed higher total cholesterol and triglycerides and Lower HDL level in haemodialysis patients which has a strong epidemiological relationship with CVD.
PTH level was significantly higher in the patients group compared to control group, and positive correlation with LVH and negative correlation with E/A parameter of the diastolic function of the left ventricle .
The echocardograohic changes are present in 75% of the dialysis patient with the concentric LVH is the leading abnormality occurring in 80% of the G1, diastolic dysfunction was present in 53% of G1. Valvular calcifications were present in 40% of G1, systolic dysfunction was present 36.3% of G1, while LA was dilated in 26, 6%. Regional wall motion abnormality was present in 33.3% of G1. Pericardial effusion presented in 16, 7 of G1, pulmonary hypertension represented in 16% of G1. Dilated right side of the heart in 3% and dilated LV in 3% of G1.