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Cardiovascular complications are the leading cause of death in patients on hemodialysis. Investigators have demonstrated that the extent and type of vascular calcification are predictors of subsequent cardiovascular mortality. Although research efforts in the past decade have greatly improved our knowledge of the multiple factors and mechanisms involved in vascular calcification in HD patients, yet many questions remain unanswered.
Hyperphosphataemia, increased calcium intake with resulting high calcium X phosphorus product and inflammation are some important causes of calcification in HD patients.
Fetuin-A a glycoprotein synthesized in the liver, has been identified as a potent circulating inhibitor of the calcification process in HD patients, and as HCV is the most common pathogen affecting the liver in Egypt.
Thus, the aim of our study was to assess the effect of HCV on Fetuin-A level in HD patients and their relation to ACI.
The study involved 40 prevalent HD patients aged above 18 years randomly selected from Ain-Shams University Medical Hospital, Cairo, Egypt .They were divided into 20 HCV +ve HD patients [Child A] (group 1a), another 20 stable HCV-ve HD patients (group 1b).They patients were furtherly divided according to ACI into22 (group 1c) with ACI<2 and 18 (group 1d) with ACI >2.
A third group of 15 healthy controls were selected (group 2).
The following lab investigations were done: serum fetuin A, bone alkaline phosphatase, hscrp, intact PTH and routine chemistry in addition to non contrast CT scan abdomen to detect ACI.
Our study showed that there wasn’t a significant difference in Fetuin-A level and ACI in HCV +ve and -ve HD patients, this may be attributed to the complexity of factors influencing them.
There was a statistically negative correlation between Fetuin-A level and AST,ALT ,total bilirubin and INR in HCV +ve HD patients, another significant negative correlation was recognized between Fetuin-A and ACI in HCV -ve HD patients and in those with ACI>2.
Our results revealed that there was a positive correlation between ACI and dialysis duration in patients with ACI>2.
Finally the multivariante analysis showed that with every year increase in age there is an increased risk of ACI by 1.1 times.