الفهرس 
List of contentsOnly 14 pages are availabe for public view
 |  | from | 2 |  |  |
| | | from | 2 | | |
Abstract
Chronic kidney disease (CKD) is a major public health issue: 11–13% of the overall world’s population suffers from this disease. In the literature, the data on the prevalence of CKD among children are scarce. In comparison with the general population, the long- term survival of children with advanced chronic kidney disease (CKD) remains low Hyperphosphatemia in chronic kidney disease (CKD) becomes more common as the disease progresses, is thought to contribute to various complications, particularly cardiovascular and bone complications in advanced CKD, and then usually necessitates therapies ranging from dietary counselling to dialysis prescription and/or drug therapyAt recent years, CKD-mineral bone disorder (CKD-MBD) is introduced as a new clinical syndrome, in which the phosphate is one of most important biochemical parameter and inducer of vascular calcification. Several studies have showed that serum levels of phosphate were linearly and independently associated with cardiovascular mortality in dialysis CKD patients. The use of phosphate binders have been associated with improved survival in HD patients The current prospective randomized control trial was conducted to evaluate the efficacy and safety of use of Sevelamer HCL and calcium-based phosphate binders in management of hyperphosphatemia in children with ESRD on regular HD. A total of 40 children (25 males and15 female) were enrolled attending Pediatric Hemodialysis Unit on Assiut Children University Hospital (AUCH) during the period from first of January 2018 to 31th December 2018 The age of the children ranged from 6 years to 18 years. They were randomly divided into to 2 groups: group A included 20 patients who received the recommended daily dose of the Sevelamer HCL phosphate binder and group B included 20 patients who received calcium-based phosphate binder.In addition to meticulous history taking and detailed clinical examination, the following investigation was done:Complete blood count (CBC), Serum urea and creatinine , serum Na, K, Ca and PO4, Alkaline phosphatase , Parathyroid hormone (PTH) and Lipid profile before and after 3 months of treatment. Also , Echocardiography was done to all patient to evaluate LVM and LVH and both systolic and diastolic function of the heart The most frequent aetiologies of CKD in those children were nephronophsiathesis (37.5%) and congenital abnormalities of the kidney and urinary tract (30%). Both studied groups had insignificant difference as regard baseline demographic, laboratory and echocardiographic data.