الفهرس 
Bone Mineral Disease and chronic Kidney Disease PatientsOnly 14 pages are availabe for public view
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Abstract
Our study was a prospective study was concluded upon 32 randomly selected patients from dialysis department in Ain Shams University Hospitals and Maadi Military Hospital. Our patients were Stable adult ESRD patients more than 18 years old on chronic hemodialysis for more than 6 months (prevalent HD patients) whose iPTH levels ranges from 100-600 pg/ml. The patients were divided into two groups (group A & group B). group A underwent dialysis with HDF and group B underwent dialysis with high flux dialyzers. Both HDF and HD were performed with ultrapure dialysis fluids.
In group A, the median age of the patients was 54 years, females represented 43.8 % of the patients and males represented 56.3% of patients, they had BMI of median 20.5 Kg/m2and mean 22.69 ± 5.62 Kg/m2.In group B, the median age of the patients was 56 years, female sex represented 18.8% of the patients and males represented 81.3% of patients, they had BMI of median 24 Kg/m2 and mean 24.19 ± 3.99 Kg/m2. There was no statistically significant difference between 2 groups as regard these demographic data.
As regard the filter used, patients in group A were maintained on hemodialysis with 1.8 m2FX 80 s filter. As for group B, patients were maintained on hemodialysis with 2.2 m2polypure H filter.
Urea reduction ratio showed statistically significant difference between pre and post-dialysis urea in each group. But there was no statistically significant between group A and group B as regard urea pre, post-dialysis and reduction ratio.
As regard HGB, TIBC, Ferritin, there was no statistically significant difference between the 2 groups. As regard HGB, no statistically significant difference between group A pre/post study and group B. There is statistically significant difference between group A pre and post study.
As regard serum calcium, patients in group A had statistically significant difference between pre and post study but no statistically significant difference between group A and group B.
HDF group had effect on Ca level, PO4 level and Ca&PO4 product and serum PTHwith statistically significant results.
As regard serum sclerostin, there was statistically significant difference betweenpre-dialysis and post-dialysis sclerostin level in HDF group prestudy as well as pre and post session in high flux group.
As regard sclerostin predialysis, there was statistically significant difference betweenHDF group pre study and poststudy.
Also there was statistically significant difference between HDF group post study pre session and high flux group pre session.
As regard BS-AP, There was statistically significant difference between HDF group post study pre session and high flux group pre session. Also, there was statistically significant difference betweenHDF group pre and post study as regard BS-AP predialysis.
However, no statistically significant difference between HDF group pre /post study as regard Correlation between Sclerostin delta change (pre session pre and post study)and different parameters Ca × PO4, PTH, BAP.
One limitation of our study is small number of patients. Furthermore, no other markers of bone metabolism (such as osteocalcin and FGF23) were available and short duration of our study. Given the clinical implications of these results, additional research is needed.
An important strength of the present study is the use of serial measurements for sScl in the survival analyses, which determine the association between sScl and clinical outcome. Secondly, randomized patients to either HD or HDF, which made it possible to analyze the causal effect of dialysis modality on sScl. Thirdly, the assessment of all sScl measurements in a single run, at a central laboratory, eliminated inter-assay variability.