الفهرس 
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Abstract
cardiovascular disease is the leading cause of mortality in dialysis patients, with a rate 10 to 30 times greater than in the general population due to chronic microinflammation which a nontraditional risk factor for atherosclerosis, has been observed commonly in patients with end stage renal disease (esrd) on dialysis and strictly correlated with the development of atherosclerosis.
fetuin-a is a circulating calcium-regulatory glycoprotein that inhibits vascular calcification in dialysis patients, and it is also a prognostic factor for dialysis patients.
fetuin-a level may predict cardiovascular mortality independently from basal vascular conditions defined by previous cardiovascular events and carotid imt.
this association between fetuin-a and cardiovascular mortality was confirmed by large cohort study of incident dialysis patients, they showed that an increase in serum fetuin-a level of 0.1 g/l was associated with a 13% lower adjusted risk of all-cause mortality.
fetuin-a is a negative acute-phase reactant, and other studies reported that interleukin 6 induces significant downregulation of fetuin -a expression in human hepatocytes
in this study, our aim is assessment of fetuin-a level and its correlation with atherosclerosis and vascular calcification development and progression in haemodialysis patients.
to achieve such target we select 90 subjects; they were classified into 3 groups:
•group (i): it comprised 10 apparently healthy volunteers.
• group (ii): it comprised 30 patients with ckd stage (4) and gfr range from 15 to 29ml/min) with mean± sd of 20±3.22 ml/min by mdrd on medical treatment not on haemodialysis.
• group (iii): it comprised 50 patients with esrd (gfr<15ml /min) mean± sd of 7.29±1.68 ml/min by mdrd on regular haemodialysis.