الفهرس 
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Abstract
Thyroid dysfunction and insulin resistance are common in patient with end stage renal disease so This study was carried-out . This study depend upon the cross-sectional study that was conducted on 60 end stage renal disease patients (GFR < 15 ml< min) present at nephrology and dialysis unit in Mansoura university hospital in comparison to 30 normal individual of the same sex and age. Our study cleared that subclinical hypothyroidism is common in patients with end stage kidney disease on dialysis than patients not began dialysis also insulin resistance increase with dialysis. Several laboratory studies done for our patients and cleared that serum phosphate , serum iron , high sensitive CRP , hemoglobin , triglycerides , Tsh and fasing insulin showed higher level in patients on dialysis than CKD patients not on dialysis . Serum calcium , cholesterol , LDL and HDL showed higher level in patients not on dialysis than patients on dialysis. HOMA-IR showed significant positive correlation with h-CRP either before or after starting of dialysis . There is negative correlation between HOMA-IR , TSH and PTH in ESRD patients not on dialysis for further future randomized controlled studies . There is negative correlation between TSH hemoglobin and fasting insulin in ESRD patients not on dialysis for further future randomized controlled studies.