الفهرس 
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Abstract
Residual kidney function is thought to be of beneficial effects for hemodialysis patients that are reflected in better control of anemia and lower need for erythropoietin dose, better control of CKD-MBD through phosphorus excretion and activation of vitamin D, and useful effects on volume control, hence lower cardiovascular risk and complications. The current work aimed to study the relation between residual kidney function in hemodialysis patients and cardiovascular changes. The present study was carried out on seventy-eight patients treated by chronic hemodialysis for more than six months in Mansoura Nephrology and Dialysis Unit. Residual kidney function was measured for patients who pass urine ≥100ml/day, and the patients were divided into two groups according to presence or absence of residual kidney function. Medical history taking and basic laboratory investigations (blood hemoglobin, and serum TSAT, ferritin, calcium, phosphorus and PTH) were performed. In addition dialysis adequacy measured by KT/V, as well as serum homocysteine levels were investigated. Moreover, Doppler echocardiography and superficial ultrasound on common carotid artery were carried out. In the present work, patients with RKF had statistically significant lower values compared to those without RKF regarding hemodialysis duration, serum homocysteine level, carotid intima media thickness, and end diastolic posterior wall thickness; while they had higher values for tricuspid valve E/A ratio. On the other hand, there was no statistically significant difference between the two study groups regarding age, gender, serum calcium, phosphorus, PTH, TSAT, ferritin, blood hemoglobin, and KT/V, as well as all the other echocardiographic data. There was a statistically significant negative correlation between RKF, on one side, and both serum homocysteine, hemodialysis duration, carotid intima media thickness, and end-diastolic posterior wall thickness, on the other side. On the other hand, it showed positive correlation with tricuspid valve E/A ratio. Positive correlation was noted between CIMT and dialysis duration, age, PWd and LVMI; while PWd showed negative correlation with interdialytic urine volume and mitral valve E/A ratio. On multivariate analysis, hemodialysis duration was the only predictor for RKF; whereas age and dialysis duration were significant predictors for CIMT; and PWd could be significantly predicted by age and homocysteine level. The data of the current results pointed out that RKF was negatively associated with serum homocysteine, a known risk factor for atherosclerosis. It was also negatively associated with CIMT and some echocardiographic findings suggestive of ventricular hypertrophy and RV diastolic dysfunction. However, multivariate linear regression failed to confirm significant major predicting effect of RKF on cardiovascular risks or changes. Conclusion: Residual kidney function is negatively associated with some risks and manifestations of atherosclerosis and some echocardiographic changes suggestive of left ventricular hypertrophy; although these results are not confirmed by multivariate analysis. Further studies adopting a prospective design with larger number of patients are needed to confirm these relations.