الفهرس 
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Abstract
Introduction: Insulin resistance is considered as a therapeutic target in patients of CKD undergoing Hemodialysis. However, management of insulin resistance in patients on hemodialysis is multifaceted. Treatment of insulin resistance in CKD patients can be achieved by recombinant human erythropoietin. As appetite is markedly reduced in uraemic patients but improved in patients on rHuEpo therapy, it was interesting to examine the relationship between plasma leptin and NPY levels in uraemic patients before and during rHuEpo treatment.
Aim: The present study is conducted to assess the possible effects of short term treatment with recombinant human erythropoietin ( rHuEpo) therapy on the degree of insulin resistance (IR), plasma leptin and neuropeptide Y concentrations in 15 haemodialysed patients (HDP) receiving rHuEpo (Epo group) compared to other 15 HDP not treated with rHuEpo (No-Epo group) .
Methods: All patients gave written consent and examined in detail and all basic laboratory investigations are done with a special emphasis on renal and various metabolic parameters. Blood samples are collected. for basic biochemical renal work up including serum fasting insulin levels, fasting blood glucose, HOMA IR ,HBA1C, leptin and NPY , Blood urea and seum creatinine.
Results: rHuEpo in study group caused significant decline of HOMA IR, serum leptin, HA1C and a significant increasing of NPY; on the other hand, control group showed insignificant changes.
Conclusion: rHuEpo treatment in haemodialysed patients with chronic renal failure is followed by improvement of appetite and insulin resistance in (Epo group) compared to (No-Epo group) .
KEY WORDS:
Erythropoietin -insulin resistance -chronic kidney disease- leptin –neuropeptid Y.