الفهرس 
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Abstract
Chronic renal failure is a major public health problem, the incidence
of chronic renal insufficiency among children is approximately 18 per
million. Renal failure is associated with multiple metabolic and
endocrinological abnormalities, one of these metabolic abnormalities is
insulin resistance, which is a primarily peripheral tissue resistance resulting
in varying degree of hyper-insulinemia and glucose intolerance.
Resistin hormone is secreted from adipose tissue with other proteins
such as leptin and aiponectin. This hormone may be involved in the
regulative processes taking place in insulin resistance.
The aim of this study was to evaluate serum concentration of resistin
in children with chronic renal failure and those on hemodialysis and to study
the effect of resistin on insulin resistance also the effect of hemodialysis on
insulin resistance.
The present study was conducted on 36 subjects subdivided into
three groups. Group (1) included 16 patients with CRF treated by regular
hemodialysis and group (2) included 10 patients with CRF on concervative
treatment, attending the pediatric department in Benha university hospital
and group (3) included (10) apparently healthy individuals of matched age
and sex. Patients with acute or chronic illness or any disease that affect renal
function resistance were excluded CRF secondary to diabetes mellitus or
diabetes mellitus secondary to CRF due to insulin resistance were excluded.
All patients were subjected to full history taking, clinical examination and
anthropometric measurement. Blood samples were withdrawn from all
subjects to assess serum level of fasting resistin, fasting insulin, fasting
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Summary and Conclusions
glucose, creatinine and BUN.
Our results showed that serum resistin level increased in both HD
and concervative treatment groups in relation to control group with higher
increase in HD group. Also found that HOMA-IR significantly increased in
concervative treatment group in relation to control group and no difference
in between HD group in relation to control group or concervative treatment
group.
The present study showed insignificant correlation between resistin
in HD & concervative treatment groups and each of HOMA-IR and It’s
parameters (F. insulin & fasting serum glucose).
Assessment of diagnostic performance of serum resistin in
diagnosing patients with CRF revealed that serum resistin at cut off value
(6.50) showed a diagnostic sensitivity 88.5% and specificity 80%.
Conclusion
The present study has been demonstrated that serum levels of
fasting resistin are increased in children with chronic renal failure with high
levels in HD patients as hemodialysis not eliminate resistin. no significant
correlation between serum resistin and insulin resistance which is
represented by HOMA-IR and it’s parameters (F. Insulin and F.serum
glucose).when the value of serum resistin level greater than or equal to 6.50
can be used as apredictor of chronic renal failure with sensitivity 88.5% and
specificity80% by using the roc curve.