الفهرس 
Chapter 1: chronic Kidney Disease (CKD)Only 14 pages are availabe for public view
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Abstract
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 different organs, especially the eyes, kidneys, nerves, heart, and blood vessels (Parchwani et al., 2012).
A decreased plasma level of vitamin C has been reported to be associated with an increased risk of cardiovascular morbidity and mortality. There is need to determine the vitamin C status of patients with chronic kidney disease and the pathophysiological role of vitamin C in these patients
The aim of this study was to evaluate the relationship between renal functions and plasma vitamin C concentration in non-diabetic and diabetic patients with CKD.
This study was conducted on 50 patients from the monofeya university hospital. The patients were selected from the department of internal medicine, nephrology division and nephrology outpatient clinic. The study was carried on who met the following criteria: (i) Estimated glomerular filtration rate (eGFR) <60mL/min/ 1.73 m2. (ii) No previous history of myocardial infarction, heart failure or stroke within 6 months; and (iii) Not taking vitamin C These patients were divided into two groups:
group 1: CKD patients with diabetes group 2: CKD patients without diabetes A written informed consent was obtained from each patient. All patients were subjected to the following: 1- Detailed history taking and full clinical examination. 2- Laboratory investigations including: a) Plasma level of vitamine C b) Blood urea
c) Serum creatinine d) HB A 1C. e) Albumine creatinine ratio in urine. All results were tabulated, statistically analyzed and discussed.
The present study revealed the following:
Plasma Vitamin C in group I ranged between 0.6-13.0 mg/l with a mean value of 5.013±3.825, while in group II it ranged between 1.4-21.5 mg/l with a mean of 10.656±6.433; and statistical comparison revealed a significant statistical increase in the mean value of vitamin C in the group II compared to group1 (t = -3.77, P = < 0.001),
There was no significant statistical difference between both groups of the study as regards weight (t = -1.598, P = 0.117),
There was no significant statistical difference between both groups of the study as regards age (t = 0.199, P = 0.843.
There was no significant statistical difference between both groups of the study as regards sex distribution (X2 = 1.430, P = 0.247),
There was no significant statistical difference between both groups as regards blood urea concentration (t = 0.104, P = 0.917),
There was no significant statistical difference between both groups of the study as regards serum level of creatinine (t = -0.439, P = 0.663),
There was no significant statistical difference between both groups as regards rate of e-GFR (t = 0.68, P = 0.50),
There was significant statistical difference between both groups as regards A/C ratio (t =3.291, P = 0.002),
There was significant statistical difference between both groups of the study as regards HbA1c concentration (t =21.035, P = 0.000),
There was no significant statistical difference between females and males of group I as regards Weight, Age, Creatinine, Urea and HbA1C, while there was more significant statistical difference as regards A/C ratio, then Vitamin C, then e GFR.
There was no significant statistical difference between females and males of group II as regards Weight, Age, Creatinine, Urea, HbA1C, Vit C, e-GFR and A/C ratio.
There was a significant positive correlation between Vitamin C level and both weight and e-GFR, in the patients of the study. There was a significant negative correlation between Vitamin C level and each of serum creatinine, blood urea, A/C ratio and glycosylated hemoglobin in the patients of the study. There was no significant correlation between Vitamin C level and age.
Renal dysfunction was associated with a decreased level of plasma vitamin C in patients with CKD, and diabetic patients showed a lower level of vitamin C at any given eGFR compared with non-diabetic patients.