الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is a worldwide public health problem. The importance of CKD arises from its global increase in incidence and prevalence. The outcomes of CKD include not only progression to renal failure but also increased risk of cardiovascular morbidity and mortality.
Calcification in the vessel walls occurs at two sites: the intima and the media. Calcification of the media occurs in the elastic lamina of the large and medium caliber arteries and it is frequent in CKD. The complications of these two types of vascular calcifications are different; however, they greatly account for the increase in morbidity and mortality of CKD patients.
The pathogenesis of vascular calcification in CKD is not well understood and similar to the general population is almost certainly multifactorial. In CKD patients, several studies have found associations of both traditional and uremic specific risk factors with calcification.
The conventional CT method seems to be simple, relatively inexpensive, and useful for an initial diagnosis of vascular calcification.
Metabolic bone disease is a common complication of CKD and is part of a broad spectrum of disorders of mineral metabolism that occur in this clinical setting. Alterations in the control mechanisms for calcium and phosphorus homeostasis occur early in the course of CKD and progress as kidney function decreases.
Our study aimed to evaluate the relation between vascular calcification (aortic and CAC) and silent vertebral fractures in patient with CKD stages 3 and 4, also their relation with biochemical markers of bone turn over including serum levels of Ca, P, Ca x P product, bone specific ALP and iPTH.
The study was conducted on 50 subjects who were divided into 2 groups as follow, Group A: 30 patients with CKD stages 3 and 4 from internal medicine departments of Alexandria Main University Hospital and Group B: 20 healthy volunteers as a control.
All subjects in the study were subjected to Full history taking, thorough clinical examination, Laboratory investigations including (complete blood picture, serum urea, serum creatinine, serum albumin, serum lipid profile, serum calcium, inorganic phosphorus & calcium x phosphorus product, serum bone specific ALP, serum iPTH and non contrast multidetector computed tomography (MDCT) for chest, abdomen & pelvis to detect vascular calcifications and silent vertebral fractures.
We found that vertebral fractures were absent in the entire patients with CKD stages 3&4 who were included in our study, but osteopenia was present in 30% of them and this was significantly higher than the control group of same age and sex (5%).
We found that none of the biochemical variables (serum calcium, serum inorganic phosphorus, calcium phosphorus product, intact PTH and bone specific ALP) showed any significant association with osteopenia in our CKD patients.