الفهرس 
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Abstract
CKD as evidenced of structural or functional kidney abnormalities (abnormal urine analysis, imaging studies or histology) that persist for at least three months with or without decreased GFR.
CKD leads to many complications as hypertension, diabetes, anemia, ROD, malnutrition, and CVD and nerve damage.
Malnutrition is recognized to be a serious and common complication of CKD and is associated with increased morbidity and mortality in children. Nutritional status should be monitored regularly in all children with CKD.
HbA1c is the predominant fraction of HbA and gives an estimate of the blood sugar level of an individual over the last 3 months. It has been observed that an HbA1c value of less than 7% reduces the micro-vascular complications in diabetic patients. However, HbA1c is not affected by blood sugar levels alone. A part from blood sugar, there are other factors that affect HbA1c.
The aim of the study was:
To assess HbA1c levels in non-diabetic children with ESRD receiving regular HD.
Our study was done on 60 subjects, 30 non-diabetic patients with CKD on regular HD 3 times per week attending to Nephrology Unit in Pediatric Department at Menoufia University Hospital as hemodialysis group and matched 30 aberrantly healthy controls as Control group.
All patients and controls were submitted to:
1. Complete history taking: detailed history taking with special emphasis on CKD course, symptom and duration of disease.
2. Complete clinical examination: it includes general examination, chest, heart, abdominal, orthopedic and neurological examination.
3. The examination also includes BP measurement and signs of anemia.
4. Anthropometric measures including: Weight, length, height and BMI.
5. Investigation which included:
• HbA1c.
• Serum FBG.
• Hb.
• HCT.
• Serum BUN and creatinine.
• Serum K, Ca and phosphate.
• Serum PTH.
As regard to demographic data , there was no important difference between cases and controls regarding to age ,gender and residence, but there were highly significant differences between cases and controls in weight ,height, BMI and BP, the cases were stunted , underweight and hypertensive.
As regard to investigation, there were a big difference between cases and controls with increased levels of HbA1c, BUN, creatinine,
PTH, K with decreased levels of Hb, HCT, Ca in cases versus normal levels in controls with no difference in FBG between them.
With correlation of HbA1c with age, weight, height and BMI, systolic and diastolic BP there was no significant correlation in cases versus controls.
Also, there was no important difference regarding HbA1c relation with FBG, Hb. HCT, PTH, Ca, phosphate BUN and creatinine in cases versus in controls.
After this study, we recommended a regular measurement of HbA1c for all non-diabetic patients with ESRD receiving HD as a marker of impaired glucose metabolism and glycemic control is necessary in these patient