الفهرس 
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Abstract
The prevalence of arterial stiffness in patients with ESRD ranges between 25 and 60%. Atherosclerotic lesions are moderately or severely advanced by the time they produce clinical signs and symptoms, so early detection and prevention of atherosclerosis are desirable.
A helpful and noninvasive method to evaluate arterial stiffness is Ischemia-modified albumin (IMA). The independent role of IMA in determining cardiovascular and all-cause mortality in hemodialysis patients has been established.
However, in hemodialysis patients, whether IMA is associated with arterial stiffness is not known. Recently, it was shown that high IMA is associated with vascular oxidative stress and inflammation. Thus, IMA may be a newly nontraditional marker of arterial stiffness.
In this cross sectional study, we performed it to investigate the relationship between IMA and arterial stiffness in hemodialysis patients.
This study was conducted on 90 ESRD hemodialysis patients. All patients collected from hemodialysis unit, Abo Elnomros central hospital, Giza governorate. They were divided into: group A: 60 patients with normal carotid intima media thickness (CIMT) and group B: 30 patients with increased CIMT.
All the participants were subjected to: Complete history taking, complete clinical examination, laboratory investigations (Urea reduction ratio, creatinine, complete blood picture, calcium, phosphorus, parathormone hormone, albumin, CRP, lipid profile), IMA levels, and measurement of carotid intima media thickness
Our study results have revealed that there was statistically significant relation found between the studied groups as regard weight and BMI, but there was no significant relation found between the studied groups as regard age, sex, dialysis vintage, HCV infection and hypertension.
There was highly significant relation between the studied groups as regard IMA and significant relation between the studied groups as regard CRP.
There was positive correlation between IMA and BMI, Total Cholesterol, and CIMT. While according to CIMT, there was positive correlation with weight, BMI and IMA.
The multivariate liner regression analysis for predictors of IMA was significantly associated with BMI, cholesterol and CIMT in hemodialysis patients with p value (0.058, 0.019, < 0.001) respectively., while for predictors of CIMT was significantly associated with weight (P<0.006), IMA (P<0.001), and creatinine (P<0.007).
The best cutoff point for IMA to differentiate between cases and controls was >230 with a sensitivity of 60%, a specificity of 90%, and an AUC of 77.1%.