الفهرس 
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Abstract
Chronic Renal Failure (CRF) is a worldwide public health problem. The social and economic consequences of chronic Renal Failure (CRF) are considerable. In addition to the economic and social effects on health services and society, the disease creates significant human suffering for the patient and his family.
Chronic renal failure is defined as a progressive loss of kidney function in which there is slowly worsening in the ability of the kidneys to remove wastes, concentrate urine or conserve electrolytes.
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
The aim of this work was to measure the prevalence of inadequate glycemic control in prevalent hemodialysis patients with diabetes in sohag city, to determine the factors that are associated with inadequate glycemic control in prevalent hemodialysis patients with diabetes in sohag city, and to determine the complications commomnly occur in prevalent hemodialysis patients with diabetes in sohag city and its relation to glycemic control.
The study included 39 person of both sexes randomly selected from Sohag city and asked to answer on the prepared questionnaire sheet. In patient with A1C > 7 (71.4%) males and (28.6%) females and percentage of males and females in patient with A1C ≤ 7 was (62.5% , 37.5% ) respectively .
The age of the study population was 20 years and older and the mean age was 49.57 in patient with A1C > 7 and 57.94 in patient with A1C ≤ 7.
The study showed that the majority of the study population had adequate glycemic control (82%) with A1C ≤ 7 and (18%) had inadequate glycemic control with A1C > 7. These results showed that the regular hemodialysis with repeated measurement of blood sugar and increase awareness about the importance of diabetes control has a role in glycemic control of the diabetic patient under hemodialysis.
The study showed that the duration of diabetes has a correlation with HBA1C which the inadequate glycemic control rising as the duration of diabetes lengthened .
As regard Epo dose the study showed that the patients with A1C ˃ 7 had a much lower EPO dose . It may be that EPO itself is playing a role in lowering blood glucose levels.
As regard change in Epo dose the study showed that there is no significant relation between change in Epo dose and glycemic control .
Our study showed that There was significant difference between groups in percentage of cases with hypoglycemia and visual complications. These complications were more among cases with inadequate glycemic control .
Recommendations
-We should increase the awareness of our hemodialysis patients about diabetes and CRF and importance of glycemic control to their health
-Regular follow up to the blood sugar should be done to all diabetic patients under hemdialysis to achieve adequate glycemic control and avoid hypoglycemia
-The diabetic care physician must educate theses cases how to recognize hypoglycemia and how to avoid and treat it.
-The erythropoietin should given to diabetic patients on hemodialysis when indicated as it improves glycemic control
-Regular examination and proper investigations must be done for early detection and management of diabetic complications in all diabetic patients under hemodialysis.