الفهرس 
Chronic kidney disease in childrenOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease is the new term defined by the National Kidney Foundation Kidney Disease and Outcome Quality Initiative group to classify any patient who has kidney damage lasting for at least 3 months with or without a decreased GFR or any patient who has a GFR of less than 60 mL/min per 1.73 m2 lasting for 3 months with or without kidney damage.
Although cardiovascular disease (CVD) is exceptional in children and young adults in the general population, it is the leading cause of death in children and adolescents on renal replacement therapy (RRT). Many children with CKD develop left ventricular hypertrophy (LVH) which is frequently severe, especially in children on prolonged dialysis therapy.
In addition, the American Heart Association announced that CKD should be included in the highest risk group for cardiovascular disease and that patients with CKD should receive aggressive therapeutic measures to reduce morbidity and mortality.
FGF23 is a protein that in humans is encoded by the FGF23 gene. FGF23 is a member of the fibroblast growth factor (FGF) family which is responsible for phosphate and vitamin D metabolism. The main function of FGF23 seems to be regulation of phosphate concentration in plasma.
Higher FGF23 is consistently associated with left ventricular hypertrophy (LVH), which is an important mechanism of congestive heart failure and arrhythmia, and a potent risk factor for mortality in CKD. Several cross-sectional studies in CKD, ESRD, and non-CKD populations demonstrated that elevated FGF23 levels are independently associated with greater left ventricular mass index and greater prevalence of LVH higher cFGF23 levels were independently associated with reduced ejection fraction, greater LVMI, and greater prevalence of concentric and eccentric LVH.
The study is aimed to assess the role of FGF23in diagnosis of left ventricular hypertrophy in children with chronic kidney diseases. This study was carried out on 50 subjects (between the ages of 1 and 18 years old) divided into two groups; group I:- 34 Patients who were under regular hemodialysis (18 males and 16 females) group II:- 16 Patients whose Suffering from chronic kidney disease but not on hemodialysis (8 males and 8 females) All of them were followed up at the Nephrology Unit of the Menoufia University Hospital from April 2018 to December 2019.
All the included patients were subjected to full history taking, complete physical examination and blood samples were collected and following other investigation were done:
Laboratory investigation:-
CBC
Blood urea nitrogen, serum creatinine , serum total calcium, phosphorous
Iron profiles
Parathyroid hormone
Fibroblast growth factor 23
Echocardiography
Statistical Analysis
- The results are expressed as means ± SD. The collected data were analyzed by SPSS-20statistical software using Paired t-test or Wilcoxon Signed
- Rank test. P-values less than 0.05 were considered statistically significant.