SUMMARY, CONCLUSIONS AND RECOMMENDATIONS- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.The present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum lipids (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol) were measured and ECG was performed.Diabetics with diabetic nephropathy had significant higher plasma TFAI level than those without nephropathy. Also, increase in TAFI level was found with progression in diabetic nephropathy; was significantly higher in patients reaching the end stages renal failure (hemodialysis and peritoneal dialysis groups) than in those still in the stages of micro- and macro- albuminuria, and higher in macroalbuminuric patients than in microalbuminuric patients.TAFI level was positively correlated with the indicators of decline in renal function and progression of diabetic nephropathy such as urinary albumin, albumin/creatinine ration, blood urea and serum creatinine. TAFI was strongly correlated with albumin/creatinine ratio much more than with urinary albumin suggesting that albumin/creatinine ratio may be a more precise measure for detection of albuminuria and decline in renal function in diabetic patients than urinary albumin.TAFI level was found to be significantly higher in dialyzed patients with diabetic nephropathy than in those still not starting dialysis and correlated positively with duration of dialysis and markers of dialysis inadequacy (raised urea and creatinine). Moreover, it was significantly higher with peritoneal dialysis than with hemodialysis in patients with diabetic nephropathy and on regular dialysis therapy.Level of TAFI was correlated positively with triglycerides and negatively with HDL-cholesterol in a significant manner in all patients with diabetic nephropathy but not in control subjectsFrom this study, it could be concluded that:1- Patients with diabetic nephropathy have elevated circulating TAFI concentration which is more obvious with the progression of the nephropathy and it is correlated with markers of decline in renal function; a finding that suggests the contribution of TAFI in the pathogenesis and progression of diabetic nephropathy through inhibition of fibrinolysis and subsequent enhancement of fibrin deposition in the renal glomeruli.2- Diabetics with diabetic nephropathy on peritoneal dialysis have a higher concentration of TFAI more than those who shifted to hemodialysis program. This may contribute to the higher cardiovascular mortality in this population.3- It is better to screen for microalbuminuria and to assess kidney function in patients with diabetes mellitus by using albumin/creatinine ratio than by urinary albumin excretion.At the end, after finishing this work, it could be recommended to do further studies considering the following:• Longitudinal study of TAFI in the same patients progressing in different stages of diabetic nephropathy• Whether TFAI inhibitors like Potato Tuber-derived Carboxypeptidase Inhibitor (PTCI) could regress the devolvement of renal failure in patients in early stages of diabetic nephropathy or not. Also, effects of PTCI on regression or prevention of atherosclerotic cardiac diseases in patients with diabetic nephropathy especially in those on peritoneal dialysis should be studied.SUMMARY, CONCLUSIONS AND RECOMMENDATIONSThe present study has been conducted with two objectives in mind; first is to detect if there is a role for Thrombin-Activatable Fibrinolysis Inhibitor, TAFI (a new potent inhibitor of fibrinolysis) in the pathogenesis and progression of diabetic nephropathy and to clarify some of factors that might be responsible-among others- for the vulnerability of patients with diabetic nephropathy to the high morbidity and mortality that has been reported in these patients. Second is to find whether TAFI level in patients dialyzed due to diabetic nephropathy is affected or not by the modality of dialysis and thereby influences cardiovascular morbidity among these patients.Forty type 2 diabetic patients in different stages of diabetic nephropathy were studied. They comprised four groups according to stage of diabetic nephropathy and according to modality of dialysis in those reaching ESRD; 10 type 2 diabetics in microalbuminuric stage, 10 type 2 diabetics in macroalbuminuric stage, 10 type 2 diabetic in end stage renal disease on regular hemodialysis, and 10 type 2 diabetic in end stage renal disease on regular peritoneal dialysis. In addition, 10 type 2 non-renal normotensive diabetic cases served as controls.All groups were matched in age and sex and all had liver enzymes, uric acid and serum electrolytes within the normal range.Plasma TAFI levels, using ELISA technique, were measured in a fasting venous blood samples. The following parameters of renal function were assessed; urinary albumin and albumin/creatinine ratio in albumiuric groups, blood urea, and serum creatinine. In addition, serum