الفهرس 
Vitamin DOnly 14 pages are availabe for public view
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Abstract
P
erformance of a successful hemodialysis procedure requires a functional vascular access providing adequate blood flow. Vascular access dysfunction is one of the leading causes of morbidity in hemodialysis patients.
Studies have reported that vascular access dysfunction is responsible for 20% of all hospital admission within hemodialysis patients.
Vitamin D deficiency (< 20 ng/L) or insufficiency (20 -29 ng /L) are common among patients with chronic kidney disease (CKD) or undergoing dialysis.
We aim to detect the correlation between serum vitamin D levels and vascular access dysfunction in regular haemodialysis patients.
This is an observational retrospective case control study. Sixty patients from both sexes, on conventional hemodialysis, were included in the study. Patients age ranged from 18 to 50 years and they were enrolled from the hemodialysis units at Ain Shams University. An informed consent was obtained from all patients.
Patients included in our study suffered from increased intima – media thickness and decreased pulse wave velocity in arteriovenous fistula, as proved by duplex ultrasound. They also had an estimated arteriovenous fistula blood flow < 800 ml / min as a marker of fistula dysfunction.
Our patients were subdivided into 2 groups: group A comprised 30 patients with hepatitis C virus infection (HCV +ve group A), and group B included 30 patients without hepatitis C virus infection (HCV -ve group B).
PTH serum median level was higher than normal limit within both groups, partially due to vitamin D deficiency. PTH level was more than twice significantly higher within the positive group as compared to the negative group (table 2), and this could be due to a less PTH hormone clearance by a less efficient dialysis quality due to a reduced access flow volume within positive patients. PTH did not show any valid correlation with each of vitamin D level within negative patients (r = 0.335, P = 0.071) or positive patients (r = - 0.124, P = 0.51) using Pearson correlation test, and access flow volume within negative patients (rs = 0.204, P = 0.28) or positive patients (rs = - 0.259, P = 0.16) using Spearman correlation test.
Serum Calcium mean level was within the accepted range within negative and positive patients and serum phosphorus mean value was much significantly higher within positive patients with much lower access flow volume (table 2), possibly due to inefficient removal of excess phosphorus. Serum phosphorus did not have any significant relationship either to vitamin D level (r = 0.082, P = 0.66) within negative patients & (r = - 0.025, P = 0.89) within positive patients, using Pearson Correlation test, OR to access flow volume (rs = - 0.167, P = 0.37) within negative patients & (rs = - 0.044, P = 0. 81) within positive patients, using Spearman Correlation test.