الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
CKD is a major health problem that is highly associated with cardiovascular disease. Cardiovascular disease is the most common cause of death in patients with chronic kidney disease (CKD) and vascular calcification is one of the strongest predictors of cardiovascular risk. A number of naturally occurring endogenous inhibitors of vascular calcification have been identified, including fetuin-A and MGP and pyrophosphate. Fetuin-A is a circulating plasma glycoprotein produced predominantly by the liver, it was identified as a serum component that co-purified with membrane vesicles and therefore potentially could be associated with reduced calcification potential. There is clinical evidence that fetuin A may be protective in ESRD patients. Its reduction may be among players of vascular calcification in ESRD patients and in calciphylaxis. The present study included 50 CRF patients. They were attending Nephrology Department of Mansoura University Hospital (MUH). Patients were diagnosed on clinical, laboratory and radiological bases. In addition to 30 apparently healthy subjects matched in age, sex and BMI to act as a control group. All subjects were subjected to history taking, clinical examination, laboratory investigations including CBC, serum creatinine, calcium, phosphorus, calcium phosphorus product(Ca•PO4), intact parathyroid hormone (iPTH) and fetuin-A. Radiological examination included Cardiac computed tomography (CT) for diagnosis of coronary artery calcification by assessment of calcium score (agatston score).There were significant reduction in hemoglobin and significant increased TLC in CRF groups compared to control. While no significant difference was noted regarding platelet count among studied groups.There were significant increase in serum creatinine, serum phosphate and calcium phosphate product in CRF groups compared to control. On the other hand there was significant decrease in serum calcium in CRF groups compared to control.As regard fetuin-A and plasma PTH, there was significant reduction of fetuin-A concentration and significant elevation of plasma PTH in all CRF groups compared to control. So, we concluded that, Vascular calcification in CKD is multifactorial dilemma that could results from the interplay of several factors that act synergistically all together.Whether reduction of fetuin-A is a mere finding resulting from consumption by the elevated calcium phosphate product or reduced as negative acute phase protein remain to be elucidated.