الفهرس 
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Abstract
Chronic Kidney Disease is a global public health problem with a rising prevalence. Cardiovascular disease (CVD) is very common in patients with chronic Kidney Disease (CKD) and is by far the leading cause of morbidity and mortality in dialysis patients. This study was conducted on Eighty six End stage kidney disease patients on Maintenance Hemodialysis from the Hemodialysis unit of the National Institue of Urology and Nephrology, Cairo, Egypt. The aim of this study was to assess the influence of the Secondary Hyperparathyroidism on the Left Ventricular Function in Maintenance Hemodialysis patients. The following patients were excluded from the study: Patients with Ischaemic Heart disease, Congenital heart diseases and Valvular heart diseases before dialysis. Patients with PTH levels less than 150 pg/ml. Patients with decompensated liver disease with ascites Patients with chronic Obstructive Airway disease. Patients not compliant to their hemodialysis sessions and without adequate hemodialysis All participants were thoroughly interrogated and examined clinically and were subjected to Complete Blood Count, Kidney Function tests, Liver Function tests (Albumin, ALT, AST), Serum Electrolytes, Lipid profile (TGs, Total Cholesterol), Fasting blood sugar, Postprandial blood sugar, HbA1C, Calcium, Phosphorus, Kt/V, URR, Serum i-PTH level, 12 lead resting ECG, Transthoracic Echocardiography.
According to the PTH level the studied patients were divided into two groups. Groups were created and 39 patients (18 male and 21 female; mean age: 49.9 ± 6.49) with PTH 150 – 300 pg/ml were placed in group I, while 47 patients (23 male, 24 female; mean age: 50.21± 8.52) with Uncontrolled Secondary Hyperparathyroidism PTH ≥ 350 pg/ml were placed in group II. The Results of the study demonstrated that the dry body weight was significantly higher in group II, while there was no significant difference between the two studied groups as regard Systolic function, Ejection Fraction, Left Ventricular hypertrophy and Diastolic Dysfunction. Our study revealed that there was a significant difference between the two groups as regard Vavular Calcification affecting Aortic and Mitral valves, being higher in group II. Serum Cholesterol, HbA1C % and Postprandial Blood sugar were significantly higher in group II which has a strong epidemiological relationship with Cardiovascular disease.