الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Objective: To evaluate the effect of PTH on glucose homeostasis parameters in chronic renal failure patients treated with hemodialysis analysing the effect of lowering PTH on these parameters. Patients and methods: The present study was conducted on forty one patients suffering from chronic renal failure who were on regular hemodialysis sessions. All patients were classified into two groups according to plasma PTH level: group A of patients with plasma PTH levels less than 450 pg/ ml including 24 patients; and group B of patients with plasma PTH level more than 450 pg/ml including 17 patients. Seven patients have been selected randomly from patients of group B and received pulsed doses of 1 gascholecalciferol. Results: There is significant increase in fasting insulin level in all patients versus control associated with increased HOMAIR an index for insulin resistance. Significant negative correlation is found between PTH and fasting insulin and HOMAIR in all patients. Patients with severe hyperparathyroidism have relatively more impaired pancreatic beta cell function in comparison to those with mild hyperparathyroidism. The pulsed dose of I.V. 1ga scholecalciferol is significantly associated with decreased PTH level and increased serum calcium. It also improved pancreatic beta cell function and insulin release. Conclusion: Insulin resistance is a conistant feature of CRF patients under hemodialysis therapy. Secondary hyperparathyroidism, a known concomittent problem in most cases of uremia is linked negatively to beta cell function. Intermittent pulsed i.v alphacalcidol is an effective method of lowering the high serum PTH and is associated with improvement of beta cell function.