الفهرس 
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Abstract
The incidence of chronic kidney disease (CKD) is reaching
an epidemic proportion worldwide. CKD is associated
with an increased risk of cardiovascular disease and chronic
renal failure (CRF). Recent professional guidelines classify the
severity of CKD into five stages based on glomerular filtration
rate (GFR) starting with stage 1, being the mildest and usually
causing few symptoms, to stage 5, being a severe illness with
poor life expectancy if untreated (Levey et al., 2002).
Hemodialysis is a method for removing waste products such
as creatinine and urea, as well as free water from the blood when
the kidneys are in renal failure. The prescription of dialysis requires
knowledge of the normal function of the kidney, patient
metabolism and physiology and dialysis technology. Measurement
of dialysis adequacy is multi-dimensional, monitoring includes
clinical assessment and objective measurement. Moreover, Kt/V as
a measureP Pof dialysis adequacy was significantly correlated to the
delta changesP Pof urea and interpreted as the fractional urea
clearance. Originaly the term was function of dialyzer clearance
(K),dialysis time (t) and urea distribution volume (V) (Kim et al.,
2007).
BTP is a secretory glycoprotein with a molecular mass of
26 kDa that belongs to the superfamily of proteins called lipocalins.
It is detected in human serum and urine. Because BTP is a low- molecular mass protein, it may be filtered through the glomerular
basement membrane. Thus, both serum and urinary BTP have been
investigated as indicators of renal dysfunction as reduction of the
number of functioning glomeruli decreases the renal clearance of
BTP and increases serum BTP concentrations. It also was shown to
be suitable as an indicator of a reduced glomerular filtration rate
even in the creatinine blind range (0TOgawa0T et al., 2006).
The aim of the present study is to evaluate the clinical
utility of beta trace protein as a novel marker of the efficiency
of dialysis in heamodialysis patients. In the present study,
serum urea, creatinine and BTP levels were evaluated as well as
glomerular filtration rate estimation using simplified MDRD
equation in addition to 2 BTP based equations in 40 patients
with renal failure before and after haemodialysis.
The current study showed a highly significant decrease in
serum levels of urea, creatinine and beta trace protein after
haemodialysis in comparison to the same patient before
haemodialysis. Moreover, dialysis adequacy by Kt/V was
significant correlated with GFR1 equation (using serum BTP
and urea).
On the other hand, a highly significant increase was
observed in GFR estimated by GFR1 (using s.BTP and s.urea),
GFR2 (using s. BTP and s. creatinine) and MDRD equation values after haemodialysis in comparison to the same patient before haemodialysis. After haemodialysis, a highly significant negative correlation was found between BTP serum levels and GFR1 equation. However, no statistically significant correlation was found between BTP serum levels neither with GFR2 nor MDRD equations values. Similarly, no statistically significant correlation was observed between serum BTP neither with serum urea nor creatinine in such patients after haemodialysis. In conclusion, serum BTP was highly significant decreased in CRF patients after haemodialysis. But, however serum BTP alone had no significant correlation with dialysis adequacy (Kt/V), the equation based on serum BTP and urea was highly significantly correlated with haemdialysis adequacy. Therefore, serum BTP could be used in a simple equation to reflect and/or assess the efficiency of haemodialysis.