الفهرس 
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Abstract
Chronic kidney disease (CKD) describes abnormal kidney function
and/or structure. Chronic kidney disease can progress to end stage kidney
disease (ESKD) in a significant percentage of people. Chronic kidney
disease is usually asymptomatic until the late stage, but it is detectable
usually by measurement of serum creatinine or urine testing for protein
(Levey et al., 2009).
Hemodialysis (HD) constitutes the most common form of renal
replacement therapy (RRT) worldwide. The goal of dialysis in patients with
end stage kidney disease (ESKD) is to restore body’s extracellular and
intracellular composition to that of normal to the greatest extent possible.
The surrogate marker for this physiological achievement of dialysis in
clinical practice is the measurement of ‘adequacy of dialysis’. Apart from
duration of dialysis and blood flow rate, body surface area of the patient,
composition of diet, nutritional status etc, may also influence the adequacy
of dialysis (Sultania et al., 2009).
Urea reduction ratio (URR) and Kt/V, are indicators of dialysis
adequacy. URR greater than 65% and a Kt/V greater than 1.2 are
recommended for adequate HD (Amini et al., 2011).
The aim of this work was epidemiological study of dialysis adequacy
in patients with ESKD, on maintenance HD, in dialysis unit, at Mehalla
General Hospital, and to evaluate the factors responsible for inadequate HD,
and how to treat that.