الفهرس 
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Abstract
Chronic kidney disease (CKD) is defined as a disease characterized by alterations in either kidney structure or function or both for at a minimum 3 months durationDisturbed Bone metabolism and other minerals dysregulation leads to vascular and soft tissue calcification is one among the foremost frequent and hazardous sequelae of CKD development and progression. These combination of manifestations is now known as a syndrome of CKD– mineral and bone disease (CKD–MBD).The aim of the work is to assess vit D levels among patients on regular hemodialysis and the effect of natural vit D replacement on ca, po4, PTH and vit D. Results from our study showed that all patients were Vit D deficient(100%). Vitamin D deficiency is defined as serum 25 (OH) D <20 ng/ml. All patients did not exceed 13.5 ng/ml and most ofthem (70%) were below 7 ng/ml when they were assessed before the replacement therapy. This observation agrees with what was reported previously by (Ngai et al., 2014) that >80% of CKD non-transplant patients had low serum 25(OH)D levels. Results of our study showed significant increase in serum calcium (±8.33 to ±8.89 p=0.008) mg/dL. Regarding phosphorous, it showed significant increase from (±4.99 to ±5.85 p=0.01) mg/dl. Results of our study showed that Serum PTH concentrations significantly decreased from baseline after the replacement therapy from (±419.30 to ±377.20 p<0.001) pg/mL. We concluded from this study that Vitamin D deficiency is Highly prevalent in hemodialysis patients and Vitamin D status should be evaluated carefully to correct the deficiency and prevent further deterioration of CKD-MBD. Vitamin D deficiency is prevalent in chronic kidney disease patients stage V on hemodialysis and using vitamin D natural analogue such as cholecalciferol will be cost effective and economic in correcting the shortage of the Vitamin and to avoid serious hazards of active forms of Vitamin D e.g. calcitrol such as hypercalemia and vascular calcification.