الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
The life span of patients with dialysis dependent chronic kidney disease is limited by the high prevalence and progression of cardiovascular disease, there is abundant evidence for a several hundred times increased risk compared with individuals with normal renal function.
Insulin resistance is closely associated with atherosclerosis and cardiovascular mortality in general population .patients with End Stage Renal Disease are known to have insulin resistance , advanced atherosclerosis , and high cardiovascular mortality rate .
The aim of this study is to evaluate whether insulin resistance is a predictor of cardiovascular death in a cohort of dialysis dependent chronic kidney disease , more over there is evidence that Angiotensin Converting Enzyme Inhibitors (ACE-I) may reduce cardiovascular risk and progression of thermogenesis process in patients undergo hemodialysis .
Our cross-sectional study trying to investigate the pathogenetic role of HCV infection in promoting coronary artery disease and its association with carotid atherosclerosis .
In this observational cohort study 65 patients included with CRF on regular HD recruited from renal dialysis unit in Internal Medicine Department, Minia University Hospital.
Conclusion
This study presented data that indicated increased insulin resistance and activated renin angiotensin system in patients with CKD on hemodialysis.
Furthermore, our data indicated that HCV infection in hemodialysis patients has an added deleterious effect on metabolic and cardiovascular parameters that at the end will participate in the development and progression of atherosclerosis in those patients. Moreover, our study provided evidence that the use of ACE inhibitors in such hemodialysis patients resulted in decrease of the atherosclerotic process and may delay progression of the cardiovascular events in such patients. At the same time, our study presented evidence for possible mechanisms that may be involved in this possible reversibility of the atherosclerotic lesions in those patients as evidenced by the decrease in the levels of ACE, Ang II and insulin resistance when Ramipril was used in treatment of a group of these hemodialysis patients.