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Evaluation Of Myocardial Function In Neonatal Sepsis Using Tissue Doppler Imaging, Fahima Mohamed Hassan, Dina Abdel Razek Midan, Afaf Hassan Sayed Ahmed El Roba, Basim Abdelfattah Ali Elgazzar

Menoufia Medical Journal

Objectives: To assess the ventricular function in neonatal sepsis using tissue Doppler imaging (TDI). Background: A leading cause of newborn morbidity and mortality is neonatal sepsis. Cardiac dysfunction is a significant side effect of severe sepsis. Methods: This study is a prospective case-control study that was conducted from August 2020 to March 2021with 50 neonates having culture-proven sepsis (cases), recruited from Neonatal Intensive Care Unit (NICU) of Menoufia University Hospital together with another 50 age and sex-matched sepsis-free neonates (control). Patients were subjected to history taking, clinical examination, routine investigations (complete blood count (CBC), quantitative C-reactive protein, ALT, AST, creatinine, …

Serum Neuron-Specific Enolase And S100Β Protein As Serum Biomarkers Of Brain Injury To Classify Outcome After Pediatric Sepsis, Fady M Elgendy, Fahima M Hasaan, Hassan S Bader, Mohamed S Rizk, Neveen M Fawzy

Menoufia Medical Journal

Objectives: To evaluate serum neuron-specific enolase and S100β protein as biomarkers for the detection of brain injury in pediatric sepsis and mortality. Background Septic-associated encephalopathy (SAE) is a common manifestation of sepsis, which associated with higher rates of mortality.

Methods: This case-control study was conducted on 45 septic cases admitted to the Pediatric Intensive Care Unit (PICU), Pediatric Department, Menoufia University Hospitals and 45 apparently healthy children. NSE and S100β protein serum biomarkers were measured by ELISA kits in the second day of sepsis diagnosis and patients were followed for a month.

Results: There was a highly significant increase in …

Prevalence Of Iron Deficiency Among Egyptian Children And Its Correlation With Growth Parameters, Ali M. El-Shafie, Zein A. Omar, Heba M. S. El Zefzaf, Kerollos S. Mahrous, Basma Y. Arabeen, Dina M. Basiony, Rehab A. Abd El-Lah, Rasha N. Eltobagy, Hala M. Goba, Mohammed M. Al-Ajoury, Wael A. Bahbah

Menoufia Medical Journal

Objectives: To estimate the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) and to assess their effects on growth.

Background: The most common micronutrient deficit worldwide is iron insufficiency. The health risks associated with both non-anemic and anemic iron deficiencies include impaired growth and neurocognitive development.

Methods: A cross-sectional study was done on randomly selected, apparently healthy 1200 children aged from 6 months up to 11 years during the period of October 2021 to March 2023. History and a full clinical examination with anthropometric assessment were completed before laboratory screening for all participants, including a complete blood count …

Study Of Ace And Rage Genes Polymorphism In Children With Type 1 Diabetes Presented By Renal Complications, Maha Atef Tawfik, Marwa Said Tawfik El-Sharawy, Naglaa Fathy Barsem

Menoufia Medical Journal

Objectives: To study the relation between angiotensin I converting enzyme (ACE) and receptor for advanced glycation end products (RAGE) genes in children with type 1 diabetes presented by renal complications. Background: In patients with type 1 diabetes, an association has been found between an insertion/deletion (I/D) polymorphism in the gene for ACE and the presence of diabetic nephropathy. Methods: A cross section study was conducted on 50 Egyptian children with type 1 diabetes presented by renal complications from our endocrinology, genetic unit and outpatient clinic in pediatric department, Menoufia University, during a period time from April 2021 to October 2022. …

Phosphorus: The Forgotten Electrolyte In The Paediatric Intensive Care Unit, Fady Mohamed Elgendy, Wafaa Abdelaziz Eladrosy, Muhammad Said El-Mekkawy

Menoufia Medical Journal

Objective To evaluate prevalence of hypophosphatemia and hyperphosphatemia and their association with outcome among critically ill children. Background Phosphorus is essential element for various biological functions but data about serum phosphorus level abnormalities among critically ill children are limited. Patients and methods Prospective observational study including children admitted into Pediatric Intensive Care Unit (PICU). Serum phosphorus was measured on admission, day4, day8, and day12. Pediatric Sequential Organ Failure Assessment (pSOFA) score was calculated on admission. Hypophosphatemia and hyperphosphatemia risk factors were determined. Results Hypophosphatemia and hyperphosphatemia were generally non-severe. Hypophosphatemic patients had higher frequency of sepsis on admission compared with …

Assessment Of Serum Copeptin Levels In Pediatric Patients With Sickle Cell Anemia, Mahmoud Ahmed El-Hawy, Amira M.F. Shehata, Basem Abd El-Fattah El-Gazzar, Ahmed Mostafa Ahmed Esmaiel, Mai El-Sayad Abd El-Hamid El-Saeedy

Menoufia Medical Journal

Objectives: To assess the serum copeptin levels in children with Sickle cell anemia. Background: Sickle cell anemia (SCA) is one of the most common hereditary diseases in the world. Copeptin is the C-terminal part of the prohormone for provasopressin and seems clinically relevant in various clinical conditions. Methods: This is a case control study conducted on 62 subjects, 31 pediatric patients with Sickle cell anemia and 31 healthy children, all aged 1 year to 18 to assess the serum copeptin levels in children with Sickle cell anemia. Who attended pediatric hematology clinics of the Menoufia university hospitals, during a period …

Assessment Of Serum Asymmetric Dimethylarginine Level In Children With Beta-Thalassemia, Seham M. Ragab, Sally M. El-Hefnawy, Eman R.A. Selima, Asmaa A. Mohmoud, Sara A. Elshehaby

Menoufia Medical Journal

Objective

The aim was to evaluate serum asymmetric dimethylarginine (ADMA) level in pediatric patients who received a diagnosis of beta-thalassemia as a predictor of endothelial dysfunction.

Background

Beta-thalassemia is one of most common global autosomal recessive disorders. It causes poor growth and skeletal abnormalities along with hemolytic anemia that regularly involves long-term blood transfusions.

Methods

This cross-sectional study included 60 children divided equally in two groups. The patient group was previously diagnosed with beta-thalassemia major (β-TM), and the control group was healthy subjects who were age, sex, and socioeconomically matched with the patient group. Both groups were evaluated regarding complete …

Feasibility Of Establishing A Neonatal Hearing Screening Program And Measuring Hearing Loss Among Neonates In Dakahlia Governorate, Soheir S. Abou El-Ella, Maha A. Tawfik, Naglaa F. Barseem, Reham M. Abobakr

Menoufia Medical Journal

Objectives

The aim was to evaluate the incidence of hearing impairment among neonates in a rural setup and detect permanent hearing impairment of moderate to severe degree in the frequency range important for speech recognition in neonates, at earliest possible time and help to provide appropriate intervention (medical/surgical/rehabilitation) following the detection of a permanent hearing impairment.

Background

Deafness is the most common curable childhood handicap. It is a well-recognized fact that unidentified hearing impairment can adversely affect optimal speech and language development and therefore academic, social, and emotional development. Universal neonatal hearing screening programs have been implemented in many developed …

Copeptin As A Diagnostic And Prognostic Biomarker For Sepsis In Pediatric Intensive Care Unit, Zein A. Omar, Fady M. El-Gendy, Eman A. Badr, Walaa M. Nabil Ibrahim

Menoufia Medical Journal

Objective

Assessment the role of copeptin as a diagnostic and prognostic biomarker for sepsis in a pediatric intensive care unit (PICU).

Background

Copeptin has been proposed as a promising biomarker for the diagnosis and prognosis of pediatric sepsis in patients with systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock.

Patients and methods

This prospective case–control study was conducted on 75 patients with sepsis admitted to the PICU of Menoufia University Hospital and 25 healthy controls. All patients are subjected to a detailed history, physical examination, and laboratory investigations. Pediatric Sequential Organ Failure Assessment, Pediatric Risk of Mortality III …

Pentraxin-3 Levels In Β-Thalassemia Major And Its Relationship With Antioxidant Capacity And Total Oxidant Stress, Farida Hussein El Rashedy, Seham Mohammed Ragab, Ashraf Abd El-Fatah Dawood, Ramy Ashmawy Ahmed El Ashmawy, Mahmoud Ahmed El Hawy

Menoufia Medical Journal

Objectives:to evaluate Pentraxin-3 Levels (PTX-3) in pediatric patients with β-thalassemia major, intermedia and minor and its relationship with antioxidant capacity and total oxidant stress.

Background: PTX-3 increases alongside with oxidant stress. Therefore, it can be used as an early diagnostic marker for inflammation.

Methods:A case control study was conducted on 60 pediatric patients with β-thalassemia enrolled from Pediatric Department, Menoufia University. Another 30age and sex matched healthy children were included as a controlgroup. The study was performed during January 2020 to January 2022.

Results: Pentraxin 3 level was higher in all β. Thalassemia patientscompared with control. Total antioxidant capacity was …

Mortality Rate Risk Factors In Neonatal Intensive Care Units In El Giza Governorate, Ghada M. Elmashad, Shimaa A. Ibrahim, Hanan M. Elsayed

Menoufia Medical Journal

Objective: This study aimed to determine the incidence of neonatal mortality percentage in NICUs in Giza Governorate hospitals for early prediction of the disease.

Background: Neonatal mortality rates defined as death of a live born newborn within the first 28 days vary greatly between countries, even within high-income countries.

Methods: A retrospective study was conducted on 155 Egyptian neonates aged from 1 day up to 4 weeks to evaluate the risk factors of the mortality rates at Giza Governorate hospitals NICU during the period from August 2021 to December 2021.

Results: We reported about 6.5% of the studied neonates experienced …

Relation Between Milk Temperature And Feeding Tolerance In Premature Infants, El-Mashad Gm, El Bastawesy N T M, El Sayed H M

Menoufia Medical Journal

Objectives: To evaluate the effect of milk temperature either at warm temperatures closer to freshly expressed breast milk versus at room temperature on feeding tolerance in premature infants.

Background:

Feeding intolerance (FI) is frequent among preterm infants in neonatal intensive care units (NICUs). It has several symptoms and is attributed to many factors including milk temperature.

Methods:

This prospective cohort study included 70 preterm neonates divided into 2 groups; group I included 35 preterm neonates fed with milk at 22– 24°C, closer to room temperature, group II: 35 preterm neonates fed with milk at 32– 34°C, closer to freshly expressed …

Therapeutic Effect Of Probiotics In Neonatal Physiological Jaundice, Ghada Mohamed El Mashad, Ayatmagdy Mohamed Abo El-Mag, Hanan Mostafa Elsayed

Menoufia Medical Journal

Objectives: The aim was to study the effect of probiotics on physiological jaundice.

Background:

Neonatal jaundice is a relatively prevalent disease. Probiotics supplementation therapy could assist to improve the recovery of neonatal jaundice.

Patients and methods: This study was double blinded randomized clinical trial which was prospectively conducted on 88 neonates admitted to neonatal intensive care units of Menoufia university hospital and Damanhour teaching hospital from January 2022 to April 2022. Infants were allocated into two groups: Probiotic group included 44 full term neonates with physiological jaundice who were given the probiotics and Placebo group included 44 neonates who were …

Urinary Neutrophil Gelatinase-Associated Lipocalin In Acute Tubular Injury Among Children With Severe Gastroenteritis, Aliaa A. Abdelaziz, Mohamed A. Elrehem Mohamed Soliman, Mostafa A. B. Etman, Sameh A.A Abd Elnaby

Menoufia Medical Journal

Background Acute kidney injury (AKI) is a serious complication in critically ill children. It is a risk factor for mortality, prolonged stays in the ICU, and prolonged mechanical ventilation. Objectives To investigate urinary neutrophil gelatinase-associated lipocalin (NGAL) concentrations as an early biomarker of prerenal AKI in severe dehydrated pediatric patients with acute gastroenteritis. Patients and methods A cross-sectional study was conducted during the period study from August 2020 till March 2021, on 69 children, aged from 1 to 108 months, at the pediatric ICU) of Faculty of Medicine, Menoufia University, after obtaining consent from their parents and caregivers. Results NGAL …

The Potential Role Of Serum Copeptin Measurement Among Critically Ill Children, Marwa S. Abohola, Mohamed S. Rizk, Muhammad S. El-Mekkawy, Nagwan Y. Saleh

Menoufia Medical Journal

Background Copeptin is a promising biomarker for determining the prognosis of many diseases such as vasopressin-dependent fluid disorders. Objective To assess the role of serum copeptin measurement in critically ill hyponatremic children admitted to the pediatric ICU. Patients and methods This prospective cohort study was conducted on 80 critically ill children and 80 healthy controls. Serum copeptin was measured within the first 24 h of pediatric ICU admission using enzyme-linked immunosorbent assay kits. Results Serum copeptin was significantly elevated among critically ill patients compared with the control group (P < 0.001). There was no significant difference between serum copeptin levels concerning the type of hyponatremia according to volume status, plasma tonicity, or even syndrome of inappropriate antidiuretic hormone secretion diagnosis (P = 0.69, 0.20, and 0.62, respectively). There was no …

Fluid Balance Among Children With Sepsis And Its Relation To Prognosis, Nagwan Y. Saleh, Mohamed S. Rizk, Sara S. El-Wazer, Ahmed S. Abo Hola

Menoufia Medical Journal

Objectives To assess fluid imbalance among critically septic children and its relation to the prognosis of these critically ill children. Background Fluid imbalance is a common adverse event in critically ill children, which may lead to oxygenation failure, mortality, and in bad need for more fluid for resuscitation. Patients and methods This prospective cohort study was conducted on 74 critically septic children admitted into the Pediatric Intensive Care Unit. Pediatric Index of Mortality II, Pediatric Risk of Mortality, and Pediatric Sequential Organ Failure Assessment scores were calculated. Fluid measurements were assessed daily for 5 days. Children were subgrouped regarding the …

Programmed Death Receptor-1 Expression In Neonatal Sepsis As A Diagnostic And Prognostic Marker, Aisha N. Omar, Dina A. Midan, Iman A. Ahmedy, Noha M. Ashour, Reem M. Elkholy

Menoufia Medical Journal

Objective To determine potential diagnostic and prognostic values of programmed death receptor-1 (PD-1) expression in neonatal sepsis. Background In neonatal ICUs across the world, sepsis is a frequent disease associated with high rates of death and morbidity. In sepsis, chronic immunosuppression following a fast proinflammatory response results in high rates of morbidity and death. PD-1 (CD279) is an immunoglobulin superfamily cell surface receptor that inhibits proinflammatory activity. Patients and methods This prospective observational study was carried out on 102 newborns. They were divided into two groups: group I (cases group) (n = 52) included newborns with suspected or proven …

Prognostic Value Of Nucleated Red Blood Cells In Critically Ill Neonates, Ghada M. El Mashad, Hanan M. El Saied, Heba A. El-Koomy, Noran T. Abo El-Khair

Menoufia Medical Journal

Objectives To evaluate nucleated red blood cells (nRBCs) as a prognostic value in critically ill neonates. Background nRBCs are premature red blood cells, are an indicator of hematopoiesis in a newborn infant, and have been known to be associated with intrauterine hypoxia. Patients and methods This cohort study included 94 newborn infants who presented to the neonatal ICU in Menoufia University and Shebin El-Kom Teaching Hospital and fulfilled the following inclusion criteria: infants with sepsis, hypoxic ischemic encephalopathy, necrotizing enterocolitis, patent ductus arteriosus, and preterm infants. Infants were only excluded if they did not perform a complete blood count during …

Evaluation Of Seroprevalence Of Dengue Virus Infection Among Patients Visiting A Tertiary-Care Center In Indore, Mahmood D. Al-Mendalawi

Menoufia Medical Journal

I refer to the interesting study by Bajpai et al. [1] published in October–December 2021 issue of the Menoufia Medical Journal. Utilizing serology, Bajpai et al. [1] found that 18.4% of the patients admitted to a tertiary‑care center located in Central India were found to be seropositive for dengue disease (DD). We believe that the following methodological limitation related to the serology used in the study could bring into question the rightness of the study results. The impact of that limitation could be explained in dual aspects. On one hand, the laboratory detection of DD is based on serology and …

Evaluation Of Pcr Technique As A Rapid Screening Method For Detection Of Group B Streptococci Colonization In Pregnant Women, Mahmood D. Al-Mendalawi

Menoufia Medical Journal

We read the interesting study by El‑edel et al. [1] published in April–June 2022 issue of the Menoufia Medical Journal. El‑edel et al. [1] studied the performance of the PCR as a screening tool for detecting group B streptococci (GBS) colonization in the urogenital tract of Egyptian pregnant women and estimated its prevalence among these pregnant women. They found that the prevalence of colonization with GBS in the studied pregnant women was 20%. The PCR had 99.0% sensitivity and 98.0% specificity with 72.11% positive predicted value and 70.4% negative predictive value [1]. They concluded that the PCR technique is a …

Salivary C-Reactive Protein, Mean Platelet Volume, And Neutrophil-Lymphocyte Ratio As Diagnostic Markers Of Neonatal Sepsis, Hanan M. El-Sayed, Rehab H. El-Arabi, Sara M. El-Deeb, Seham M. Ragab

Menoufia Medical Journal

Background Till now, salivary C-reactive protein (CRP), mean platelet volume (MPV), and neutrophil-lymphocyte ratio (NLR) have not been studied as markers for diagnosis of neonatal sepsis. Objectives To assess the applicability of salivary CRP, MPV, and NLR as diagnostic markers in preterm neonates with neonatal sepsis. Patients and methods A case–control study was conducted on 184 newborns from the neonatal ICU at Menoufia University Hospital and Qwesna General Hospital from 2021 to 2022. All selected newborns were divided into group I, which included 92 neonates diagnosed as having neonatal sepsis, and group II, which included 92 apparently healthy neonates. Full …

Carboxyhemoglobin As An Early Predictor For Pathological Hyperbilirubinemia In Preterm Neonates, Dina A. Midan, Maather K. Elshafie, Noha M. Ashour, Rehab H. Ali Mostafa

Menoufia Medical Journal

Background Hyperbilirubinemia is the most common condition requiring evaluation and treatment in newborns. Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life. Objectives To assess the role of carboxyhemoglobin (COHb) as an early predictor for pathological hyperbilirubinemia in preterm neonates. Patients and methods This prospective cohort study was conducted on 74 preterm newborns of less than 37 weeks gestation of both sexes, admitted in the first day of life at the neonatal ICU of Menoufia University Hospital from August 2019 to August 2020. All included newborns had serum COHb percentage and total …

Assessment Of Levels Of Ischemia-Modified Albumin In Neonates With Transient Tachypnea Of The Newborn, Ali R. El-Marakby, Fady M. El-Gendy, Noha M. Ashour, Sara M. El-Deeb

Menoufia Medical Journal

Objective To assess the diagnostic and prognostic values of ischemia-modified albumin (IMA) in neonates with transient tachypnea of the newborn (TTN). Background TTN results from failure of the newborn to effectively clear fetal lung fluids after birth. TTN represents a common etiology of respiratory distress in term newborns. IMA is a modification of serum albumin and results from oxidative stress that occurs during ischemic events regardless of its tissue specificity. Patients and method This prospective case–control study was conducted on 88 full-term newborns, who were admitted to the neonatal ICU of Menoufia University Hospital. They were divided into two groups, …

Urine-Based Detection Of Intestinal Mucosal Cell Damage In Neonates With Suspected Necrotizing Enterocolitis, Fady M. Elgendy, Hanan M. El-Sayed, Nesma B. El-Desokyc, Nouran T. Aboelkhair

Menoufia Medical Journal

Objectives To assess the diagnostic value of the urinary intestinal fatty acid-binding protein (iFABP) in neonatal necrotizing enterocolitis (NEC) in the early stage of the disease. Background NEC is a severe acute gastrointestinal disease affecting preterm newborns. iFABP has been associated with injury to the intestinal mucosa common to NEC. Patients and methods This cross-sectional study included 40 preterm neonates divided into two groups: group I included 20 preterm neonates with suspected NEC according to Modified Bell Staging Criteria for NEC and group II included 20 preterm neonates with non-NEC. All the included participants underwent full history taking, full examination, …

The Validity Of The Disseminated Intravascular Coagulopathy Score Among Septic Children, Ahmed B. Rashad, Mona S. Habib, Nagwan Y. Saleh, Wafaa M. Abo El Fotoh

Menoufia Medical Journal

Objective To assess whether the disseminated intravascular coagulation (DIC) score is more valuable than other mortality scores in predicting in-hospital mortality in septic children admitted to the pediatric intensive care unit (PICU). Background Sepsis is one of the most common causes of death among hospitalized children in the PICU. Patients and methods This prospective observational study was conducted on 96 critically ill children. Laboratory and clinical data were measured within 24 h of PICU admission. Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality II (PIM II), and Pediatric Sequential Organ Failure Assessment (pSOFA) scores were calculated. DIC score was …

Serum Levels Of Homocysteine And Interleukin-6 In Children With Idiopathic Epilepsy In Menoufia University Hospital, Ahmed T. Mahmoud, Maha A. El-Bassuoni, Mohamed S. El Haroun, Shaimaa Ibrahim Zalat

Menoufia Medical Journal

Background Epileptic seizures are due to excessive, abnormal, or synchronous signaling, or depolarization, in the brain cells. Homocysteine (Hcy) and interleukin-6 (IL-6) are a thiol metabolite derived from the demethylation of methionine. It is widely known that folate deficiency takes place in a few epileptic patients taking antiepileptic drugs (AEDs), causing decreased remethylating or transculturation of Hcy. The effect of systemic inflammatory responses on generalized motor seizures in pediatric patients with epilepsy needs to be evaluated. Objectives To measure serum levels of Hcy and IL-6 in children with idiopathic epilepsy in relation to their clinical findings. Patients and methods A …

Anthropometry Of The Lower Zone Of The Face In Preschool-Aged Children, Assem M. Salama, Maha A. Tawfik, Naglaa F. Barseem

Menoufia Medical Journal

Objective To assess anthropometry of the lower zone of the face (philtrum length, philtrum width, intercommissural distance, and lower lip to chin length) in preschool-aged children in Menoufia Governorate. Background All health personnel having a responsibility toward the care of children should be sufficiently familiar with normal patterns of growth and milestones so that they can recognize overt deviations from the normal range as early as possible, for underlying disorders to be identified and given appropriate attention. Patients and methods This was a cross-sectional study conducted on 516 Egyptian apparently healthy preschool children of both sexes (between 3 and 6 …

Neuroglobin As A Novel Biomarker In Childhood Seizures, Heba B. Abd Elsalam, Sameh A. Abd Elnaby, Sara M. Eldeeb, Yasmeen K E. El-Fiky

Menoufia Medical Journal

Objectives The aim of this study is to investigate the possible role of neuroglobin as a novel biomarker in children with febrile seizures and epileptic children. Background Neuroglobin is a new globin member that is highly expressed in the central and peripheral nervous system. Patients and methods This case–control study has been conducted on 75 children, divided into three groups: group I included children with simple febrile convulsions, group II included children with newly diagnosed idiopathic epilepsy, and group III included healthy children selected as controls. Serum neuroglobin assay, complete blood count, C-reactive protein level, random blood sugar, serum electrolytes, …

Role Of Pancreatic Stone Protein In Critically Ill Children, Mina L. Hana, Mona S E. Habieb, Muhammad S. El-Mekkawy, Nagwan Y. Saleh

Menoufia Medical Journal

Objective To assess the role of pancreatic stone protein (PSP) in evaluation of critically ill children admitted to a pediatric intensive care unit (PICU). Background PSP was suggested to be a promising biomarker for determining critical illness severity among pediatric children. Patients and methods This prospective observational study was conducted on 75 critically ill children and 15 healthy controls. Serum PSP was measured in patients within 24 h of PICU admission and on healthy controls with commercially available enzyme-linked immunosorbent assay kits. Results Serum level of PSP was significantly elevated among patients than controls (P < 0.001). The most common cause of PICU admission was respiratory illness (44%). Besides, C-reactive protein, white blood cell count, and absolute neutrophil count were significantly elevated among patients compared with controls (P = 0.001, 0.005, …

Study Of Klotho Polymorphism In Egyptian Children With Chronic Kidney Disease On Regular Hemodialysis: Single-Center Study, Fatma A. Radwan, Maha A. Tawfik, Mohamed Sh. Elharoun

Menoufia Medical Journal

Background Secondary hyperparathyroidism and bone fractures are common complications of chronic kidney diseases (CKD). Klotho (KL) protein is a coreceptor for fibroblast growth factor 23 and hence is involved in maintaining endocrine-system homeostasis and reduces cell death. Furthermore, KL is a valuable regulating factor in calcium/phosphate (Ca/P) metabolism. Objective To identify the KL polymorphism rs9536314 and its relationship with Ca/P metabolism and parathyroid-hormone (PTH) concentrations in children on regular hemodialysis (HD). Patients and methods A cross-sectional study was conducted for 6 months, from December 2020 to June 2021, on 50 pediatric patients with CKD on regular HD and an exact …