الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Anemia is a hallmark for CRF patients. It reduces quality of life and is a risk factor for early death. The present study aimed at clarification of some of the possible biochemical causative factors of anemia in CRF which are : folic acid deficiency, oxidative stress (vitamin E and vitamin C) and creatine contents in RBCs as an index of red cell age. This study carried out on 35 patients suffering from CRF, including 15 patients under conservative treatments, 10 patients under hemodialysis for less than one year and 10 patients under hemodialysis for more than one year beside 10 healthy subjects of matched age to act as a reference group. Patients were selected from the outpatient and the inpatient clinics of Internal Medicine department of Mansoura University Hospital. All cases and controls were subjected to the following: Through history and clinical examination. Laboratory investigations: Kidney function tests, Liver function tests, Complete blood picture, Folic acid concentration (serum and RBCs), Vitamin E, Vitamin C and Red blood cell creatine. There is significant increase in red cell creatine and serum creatinine and significant decrease in creatinine clearance in all studied groups compared to control group. There is significant decrease in HB level and Hct value and significant increase in MCV and MCH with no significant changes in MCHC in all studied groups compared to control group There is significant decrease in folic acid level both in serum and red cell in group of patients of macrocytosis than that of normocytic anemia Comparison of vitamin status between studied groups revealed significant decrease in folic acid concentration in RBCs in group I compared to control group and in serum in group I and II compared to the control group. Significant decrease is observed in both vitamin C and vitamin E in all studied groups compared to the control group. In hemodialyzed group of patients there was a significant negative correlation between serum creatinine and HB, significant positive correlation between vitamin E and red cell folic acid, and negative correlation between red cell creatine and serum folic acid. In non hemodialyzed group of patients there is significant negative correlation between red cell creatine and HB and significant negative correlation between serum creatinine and HB. There is significant negative correlations between serum creatine and red cell folic acid, red cell creatine and serum folic acid and red cell creatine and vitamin E, serum creatinine and HB. Significant positive correlations are observed between vitamin C and HB, vitamin E and red cell folic acid, red cell folic acid and HB, serum folic acid and red cell folic acid and vitamin E and serum folic acid in all studied patient groups. Conclusion Anemia of CRF results from an interplay of several factors including augmented oxidative stress. Antioxidant deficiency caused by impaired vitamin status is accused to be determinant for this condition.