Evaluation some Biochemical Levels in Patients undergoing Hemodialysis in Baghdad Governorate


  • Hussein Faleh Hassen Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq. http://orcid.org/0000-0001-7615-1049
  • Makarim Qassim Dawood Al-Lami Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq.
  • Ali J Hashim Al-Saedi Nephrologist – Center, Kidney Diseases and Transplantation-Medical City, P.O. Box 61023, Baghdad, Iraq.


CRP, Hemodialysis, Blood serum, Leptin


The objective of investigating some biochemical parameters like urea, creatinine, Hb and other parameters as CRP and leptin in the serum of ESRD patients on hemodialysis pre-dialysis.

Method: Sample of 250 cases which consists of the patient with ESRD, their mean ages were 52.66 ± 12.55 years with ranged from 18-83. Moreover, under hemodialysis treatment not less than three months. Apparently, 20 healthy subjects were selected as (control) for comparison.

Results: The results showed that there was a significant increase (p<0.01) in the serum urea, creatinine, CRP, and leptin. While, revealed significant (p< 0.05) decrease in the levels of uric acid, serum glucose, albumin, inorganic phosphorus, potassium, Hb and platelet in patients before dialysis compared to the control group. Non-significant (p>0.05) is in total cholesterol, calcium and total protein in patients undergoing hemodialysis which was compared to the control group. It is concluded from the findings of the present study, it shows a highly significant increased serum concentration of leptin as well as, elevated serum values of CRP. Whereas a highly significant decrease in GFR and CrCl result from loss of the ability of the kidney to clearance. Also, abnormal mineral parameters and hematological parameters. According to the results of this study, serum total protein and cholesterol cannot be used, as a diagnostic marker of nutrition disorders in patients on regular hemodialysis requires further investigation and clarification.


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Meyer, T.W. & Hostetter, T.H. (2007). Uremia. N. Engl. J. Med., 357(13): 1316–1325. https://doi.org/10.1056/NEJMra071313.

Al-Khoury, S., Afzali, B., Shah, N., Thomas, S., Gusbeth-Tatomir, P., Goldsmith, D. & Covic, A. (2007). Diabetes, kidney disease and anaemia: time to tackle a troublesome triad? Int. J. Clin. Pract., 61(2): 281–289. https://doi.org/10.1111/j.1742-1241.2006.01259.x.

Kumar, S., Bogle, R. & Banerjee, D. (2014). Why do young people with chronic kidney disease die early? World J. Nephrol., 3(4): 143–155. https://doi.org/10.5527/wjn.v3.i4.143.

Mathenge, R.N., McLigeyo, S.O., Muita, A.K. & Otieno, L.S. (1993). The spectrum of echocardiographic findings in chronic renal failure. East Afr. Med. J., 70(2): 107–111.

Sahin, H., Uyanik, F., Inanç, N. & Erdem, O. (2009). Serum zinc, plasma ghrelin, leptin levels, selected biochemical parameters and nutritional status in malnourished hemodialysis patients. Biol. Trace Elem. Res., 127(3): 191–199. https://doi.org/10.1007/s12011-008-8238-0.

Campfield, L.A., Smith, F.J., Guisez, Y., Devos, R. & Burn, P. (1995). Recombinant mouse OB protein: evidence for a peripheral signal linking adiposity and central neural networks. Science, 269(5223): 546–549. https://doi.org/10.1126/science.7624778.

Sanjay, R., Kumar, Y., Babu, K., Hegde, S., Ballal, S. & Tatu, U. (2002). Evaluation of the role of serum leptin in hemodialysis patients. Indian J. Nephrol., 12(3): 69-72.

Bossola, M., Muscaritoli, M., Valenza, V., Panocchia, N., Tazza, L., Cascino, A., Laviano, A., Liberatori, M., Lodovica Moussier, M., Rossi Fanelli, F. & Luciani, G. (2004). Anorexia and serum leptin levels in hemodialysis patients. Nephron Clin. Pract., 97(3): c76–c82. https://doi.org/10.1159/000078634.

Cooper, B.A., Branley, P., Bulfone, L., Collins, J.F., Craig, J.C., Fraenkel, M.B., Harris, A., Johnson, D.W., Kesselhut, J., Li, J.J., Luxton, G., Pilmore, A., Tiller, D.J., Harris, D.C. & Pollock, C.A. (2010). A randomized, controlled trial of early versus late initiation of dialysis. N. Engl. J. Med., 363(7): 609–619. https://doi.org/10.1056/NEJMoa1000552.

Nesrallah, G.E., Mustafa, R.A., Clark, W.F., Bass, A., Barnieh, L., Hemmelgarn, B.R., Klarenbach, S., Quinn, R.R., Hiremath, S., Ravani, P., Sood, M.M. & Moist, L.M. (2014). Canadian Society of Nephrology 2014 clinical practice guideline for timing the initiation of chronic dialysis. CMAJ, 186(2): 112–117. https://doi.org/10.1503/cmaj.130363.

Zilva, J.F., Pannall, P.R. & Mayne, P.D. (1994). Clinical chemistry in diagnosis and treatment. 6th ed., Edward Arnold, London.

Schilthuizen, S., Batenburg, L., Simonis, F. & Vercauteren, F. (2015). Device for the removal of toxic substances from blood: Google Patents.

Karkar, A. (2012). Modalities of hemodialysis: quality improvement. Saudi J. Kidney Dis. Transpl., 23(6): 1145–1161. https://doi.org/10.4103/1319-2442.103553.

Uchida, S. (2011). Differential diagnosis of chronic kidney disease (CKD): By primary diseases. Japan Med. Assoc. J., 54(1): 22–26.

Ul Amin, N., Mahmood, R.T., Asad, M.J., Zafar, M. & Raja, A.M. (2014). Evaluating Urea and Creatinine Levels in Chronic Renal Failure Pre and Post Dialysis: A Prospective Study. J. Cardiovasc. Dis., 2(4): 182-185.

Levey, A.S., Stevens, L.A., Schmid, C.H., Zhang, Y.L., Castro, A.F., 3rd, Feldman, H.I., Kusek, J.W., Eggers, P., Van Lente, F., Greene, T. & Coresh, J. (2009). A new equation to estimate glomerular filtration rate. Ann. Intern. Med., 150(9): 604–612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006.

Pierrat, A., Gravier, E., Saunders, C., Caira, M.V., Aït-Djafer, Z., Legras, B. & Mallié, J.P. (2003). Predicting GFR in children and adults: a comparison of the Cockcroft-Gault, Schwartz, and modification of diet in renal disease formulas. Kidney Int., 64(4): 1425–1436. https://doi.org/10.1046/j.1523-1755.2003.00208.x.

Mehdi, W.A., AL-Helfee, W.A. & Dawood, A.S. (2012). Study of Several Anti oxidants, Total Acid Phosphatase, Prostatic Acid Phosphatase, Total and Free Prostate-Specific Antigen in Sera of Man with Chronic kidney failure. Kerbala Journal of Pharmaceutical Sciences, 4: 155–165.

Porth, C.M. (2007). Essentials of Pathophysiology: Concepts of Altered Health States. 2nd ed., Lippincott Williams & Wilkins, Philadelphia, pp. 559-574.

Farhan, O.L. (2013). Determination of Several Biochemical Markers in Sera of Patients with Kidney Diseases. Journal of Al-Nahrain University, 16(3): 40-45.

Merzah, K.S. & Hasson, S.F. (2015). The Biochemical Changes in Patients with Chronic Renal Failure. Int. J. Pharma Med. Biol. Sci., 4(1): 75-79.

Hasan, D. (2015). Assessment of Hepcidin, Ferritin and CRP in Anemic End Stage Renal Disease Patients on Hemodialysis. M.Sc. Thesis, College of Medicine, University of Baghdad.

Hussien, N.A., Rashad, N.M., Mahmoud, A.A., Mousa, M.M., Aly, M.A. & Raafat, N. (2016). Association of Serum Leptin with Inflammation, Anemia and Body Mass Index in Egyptian Chronic Hemodialysis Patients. Int. J. of Adv. Res., 4(3): 1316-1328.

Montazerifar, F., Karajibani, M., Hassanpour, Z. & Pourmofatteh, M. (2015). Study of Serum Levels of Leptin, C-Reactive Protein and Nutritional Status in Hemodialysis Patients. Iran. Red Crescent Med. J., 17(8): e26880. https://doi.org/10.5812/ircmj.26880.

Kang, D.H. & Chen, W. (2011). Uric acid and chronic kidney disease: new understanding of an old problem. Semin. Nephrol., 31(5): 447–452. https://doi.org/10.1016/j.semnephrol.2011.08.009.

Meenakshi, G.G. (2016). Effect of dialysis on certain biochemical parameters in chronic renal failure patients. Int. J. Contemp. Med. Res., 3(10): 2869-2871.

Athab, A.M., Ali, N.K.M. & Ahmed, L.T. (2016). C-Reactive Protein and Renal Function Tests in Chronic Renal Failure Patients on Hemodialysis and Kidney Transplantation. Int. J. Med. Pharm. Sci., 6(3): 51-60.

Adejumo, O.A., Okaka, E.I., Okwuonu, C.G., Iyawe, I.O. & Odujoko, O.O. (2016). Serum C-reactive protein levels in pre-dialysis chronic kidney disease patientsin southern Nigeria. Ghana Med. J., 50(1): 31–38. https://doi.org/10.4314/gmj.v50i1.5.

Carrie, B.J., Golbetz, H.V., Michaels, A.S. & Myers, B.D. (1980). Creatinine: an inadequate filtration marker in glomerular diseases. Am. J. Med., 69(2): 177–182. https://doi.org/10.1016/0002-9343(80)90376-9.

Higgins, C. (2016). Urea and creatinine concentration, the urea:creatinine ratio. Retrieved from https://acutecaretesting.org/en/articles/urea-and-creatinine-concentration-the-urea-creatinine-ratio.

Abdul Wahid, H.H., Turki, K.M. & AI-Tharb, A.Y. (2006). Interleukin-6 Level in serum of Iraqi Patients on Maintenance Hemodialysis Therapy. J. Fac. Med. Bagdad, 48(4): 431–434. https://doi.org/10.32007/jfacmedbagdad.4841474.

Lefta, A.A., Hadiwa, S.M. & AL-Atrakchi, S.A. (2009). Biochemical studies for some enzymes in sera of patients with renal failure. Journal of Kerbala University, 5(4): 166–177.

Mason, P.D. & Pusey, C.D. (1994). Glomerulonephritis: diagnosis and treatment. BMJ, 309(6968): 1557–1563. https://doi.org/10.1136/bmj.309.6968.1557.

Langenberg, C., Wan, L., Bagshaw, S.M., Egi, M., May, C.N. & Bellomo, R. (2006). Urinary biochemistry in experimental septic acute renal failure. Nephrol. Dial. Transplant., 21(12): 3389–3397. https://doi.org/10.1093/ndt/gfl541.

Kaysen, G.A. (2003). Serum albumin concentration in dialysis patients: Why does it remain resistant to therapy? Kidney Int., 64: S92–S98. https://doi.org/10.1046/j.1523-1755.64.s87.14.x.

Carrero, J.J., Stenvinkel, P., Cuppari, L., Ikizler, T.A., Kalantar-Zadeh, K., Kaysen, G., Mitch, W.E., Price, S.R., Wanner, C., Wang, A.Y., ter Wee, P. & Franch, H.A. (2013). Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). J. Ren. Nutr., 23(2): 77–90. https://doi.org/10.1053/j.jrn.2013.01.001.

UK Prospective Diabetes Study Group (1998). Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ, 317(7160): 703–713. https://doi.org/10.1136/bmj.317.7160.703.

Liebau, M.C., Braun, F., Höpker, K., Weitbrecht, C., Bartels, V., Müller, R.U., Brodesser, S., Saleem, M.A., Benzing, T., Schermer, B., Cybulla, M. & Kurschat, C.E. (2013). Dysregulated autophagy contributes to podocyte damage in Fabry's disease. PloS One, 8(5): e63506. https://doi.org/10.1371/journal.pone.0063506.

Chandna, S.M., Kulinskaya, E. & Farrington, K. (2005). A dramatic reduction of normalized protein catabolic rate occurs late in the course of progressive renal insufficiency. Nephrol. Dial. Transplant., 20(10): 2130–2138. https://doi.org/10.1093/ndt/gfh940.

Afshar, R., Sanavi, S. & Izadi-Khah, A. (2007). Assessment of nutritional status in patients undergoing maintenance hemodialysis: a single-center study from Iran. Saudi J. Kidney Dis. Transpl., 18(3): 397–404.

Sathiyanarayanan, S., Pawar, S.M. & Reddy, E.P. (2013). Serum Lipid Profile in Chronic Renal Failure and Haemodialysis Patients. J. Curr. Trends Clin. Med. Lab. Biochem., 1(3): 36-41.

Kaysen, G.A. (2001). The microinflammatory state in uremia: causes and potential consequences. J. Am. Soc. Nephrol., 12(7): 1549–1557. https://doi.org/10.1681/ASN.V1271549.

Kaur, S., Singh, N.P., Jain, A.K. & Thakur, A. (2012). Serum C-reactive protein and leptin for assessment of nutritional status in patients on maintenance hemodialysis. Indian J. Nephrol., 22(6): 419–423. https://doi.org/10.4103/0971-4065.106032.

Vaziri, N.D. (2006). Dyslipidemia of chronic renal failure: the nature, mechanisms, and potential consequences. Am. J. Physiol. Renal Physiol., 290(2): F262–F272. https://doi.org/10.1152/ajprenal.00099.2005.

Mustafa, L.A., Al-Abachi, S.Z. & Khalaf, D.S. (2008). Some Biochemical Changes in Serum of Hemodialysis Patients. National J. Chem., 32: 695-700.

Baigent, C. & Wheeler, D.C. (2000). Should we reduce blood cholesterol to prevent cardiovascular disease among patients with chronic renal failure? Nephrol. Dial. Transplant., 15(8): 1118–1119. https://doi.org/10.1093/ndt/15.8.1118.

Traynor, J.P., Thomson, P.C., Simpson, K., Ayansina, D.T., Prescott, G.J. & Mactier, R.A. (2011). Comparison of patient survival in non-diabetic transplant-listed patients initially treated with haemodialysis or peritoneal dialysis. Nephrol. Dial. Transplant., 26(1): 245–252. https://doi.org/10.1093/ndt/gfq361.

Sultan, A. (2011). Evaluation of hs-CRP, albumin and some trace elements in sera of patients with renal failure on hemodialysis. M.Sc. Thesis, College of Science, University of AL-Mustansiriya.

Mohammed-Jumaah, I.A. (2013). A study of some biochemical parameters in blood serum of patients with chronic renal failure. Journal of Basrah Researches (Sciences), 39(4): 20-32.

Shrishrimal, K., Hart, P. & Michota, F. (2009). Managing diabetes in hemodialysis patients: observations and recommendations. Cleve. Clin. J Med., 76(11): 649–655. https://doi.org/10.3949/ccjm.76a.09054.

Viaene, L., Meijers, B.K., Vanrenterghem, Y. & Evenepoel, P. (2012). Evidence in favor of a severely impaired net intestinal calcium absorption in patients with (early-stage) chronic kidney disease. Am. J. Nephrol., 35(5): 434–441. https://doi.org/10.1159/000338299.

Al-Rubae’I, S.H.N., Al-Khayat, T.H. & Muftin, N.Q. (2010). Free Fatty Acids and Biochemical Changes in Iraqi patients with Chronic Renal Failure. Baghdad Sci. J., 7(1): 654-662. https://doi.org/10.21123/bsj.2010.7.1.654-662.

Kalantar-Zadeh, K., Gutekunst, L., Mehrotra, R., Kovesdy, C.P., Bross, R., Shinaberger, C.S., Noori, N., Hirschberg, R., Benner, D., Nissenson, A.R. & Kopple, J.D. (2010). Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clin. J. Am. Soc. Nephrol., 5(3): 519–530. https://doi.org/10.2215/CJN.06080809.

Freethi, R., Raj, A.V., Ponniraivan, K., Khan, M.R., Sundhararajan, A. & Venkatesan (2016). Study of serum levels of calcium, phosphorus and alkaline phosphatase in chronic kidney disease. Int. J. Med. Res. Health Sci., 5(3): 49–56.

Abdul-Sattar, S. (2007). Phosphatases and osteodystrophy in chronic renal failure as related to oxidative stress. B.H.D. Thesis, College of Science, University of Baghdad.

Muftin, N. (2008). Biochemical changes in Iraqi patients with chronic renal failure after renal dialysis. M.Sc. Thesis, College of Science, University of AL-Mustansiriya.

Sigrist, M.K., Taal, M.W., Bungay, P. & McIntyre, C.W. (2007). Progressive vascular calcification over 2 years is associated with arterial stiffening and increased mortality in patients with stages 4 and 5 chronic kidney disease. Clin. J. Am. Soc. Nephrol., 2(6): 1241–1248. https://doi.org/10.2215/CJN.02190507.

Albaaj, F. & Hutchison, A. (2003). Hyperphosphataemia in renal failure: causes, consequences and current management. Drugs, 63(6): 577–596. https://doi.org/10.2165/00003495-200363060-00005.

Bailie, G.R. (2004). Calcium and phosphorus management in chronic kidney disease: challenges and trends. Formulary, 39(7): 358–365.

Rastegar, A. & Soleimani, M. (2001). Hypokalaemia and hyperkalaemia. Postgrad. Med. J., 77(914): 759–764. https://doi.org/10.1136/pmj.77.914.759.

Ahmed, J. & Weisberg, L.S. (2001). Hyperkalemia in dialysis patients. Semin Dial., 14(5): 348–356. https://doi.org/10.1046/j.1525-139x.2001.00087.x.

Williams, M.E. (2006). Coronary Revascularization in Diabetic Chronic Kidney Disease/End-Stage Renal Disease: A Nephrologist’s Perspective. Clin. J. Am. Soc. Nephrol., 1(2): 209–220. https://doi.org/10.2215/CJN.00510705.

Van Biesen, W., Vanholder, R. & Lameire, N. (2006). Defining acute renal failure: RIFLE and beyond. Clin. J. Am. Soc. Nephrol., 1(6): 1314–1319. https://doi.org/10.2215/CJN.02070606

Sreenivasulu, U., Bhagyamma, S.N. & Anuradha, R. (2016). Study of Serum Electrolyte Changes in End Stage Renal Disease Patients Before and After Hemodialysis Sessions: A Hospital Based Study. Sch. Acad. J. Biosci., 4(3B): 283-287.

Nagaraj, J., Vijayadas, Venkatesh, D., Radhika, K. & Raju, S.V.R. (2014). Correlation of leptin levels and total body fat in patients with chronic kidney disease on hemodialysis. Res. J. Pharm. Biol. Chem. Sci., 5(4): 789-795.

Johansen, K.L., Mulligan, K., Tai, V. & Schambelan, M. (1998). Leptin, body composition, and indices of malnutrition in patients on dialysis. J. Am. Soc. Nephrol., 9(6): 1080–1084. https://doi.org/10.1681/ASN.V961080.

Beberashvili, I., Sinuani, I., Azar, A., Yasur, H., Feldman, L., Efrati, S., Averbukh, Z. & Weissgarten, J. (2009). Nutritional and inflammatory status of hemodialysis patients in relation to their body mass index. J. Ren. Nutr., 19(3): 238–247. https://doi.org/10.1053/j.jrn.2008.11.007.

Tsujimoto, Y., Shoji, T., Tabata, T., Morita, A., Emoto, M., Nishizawa, Y. & Morii, H. (1999). Leptin in peritoneal dialysate from continuous ambulatory peritoneal dialysis patients. Am. J. Kidney Dis., 34(5): 832–838. https://doi.org/10.1016/S0272-6386(99)70039-9.

Babaei, Z., Moslemi, D., Parsian, H., Khafri, S., Pouramir, M. & Mosapour, A. (2015). Relationship of obesity with serum concentrations of leptin, CRP and IL-6 in breast cancer survivors. J. Egypt. Natl. Canc. Inst., 27(4): 223–229. https://doi.org/10.1016/j.jnci.2015.09.001.

Stenvinkel, P., Heimbürger, O. & Lönnqvist, F. (1997). Serum leptin concentrations correlate to plasma insulin concentrations independent of body fat content in chronic renal failure. Nephrol. Dial. Transplant., 12(7): 1321–1325. https://doi.org/10.1093/ndt/12.7.1321.

Schwartz, M.W., Baskin, D.G., Bukowski, T.R., Kuijper, J.L., Foster, D., Lasser, G., Prunkard, D.E., Porte, D., Woods, S.C., Seeley, R.J. & Weigle, D.S. (1996). Specificity of leptin action on elevated blood glucose levels and hypothalamic neuropeptide Y gene expression in ob/ob mice. Diabetes, 45(4): 531–535. https://doi.org/10.2337/diab.45.4.531.

Nand, N., Aggarwal, H.K., Yadav, R.K., Gupta, A. & Sharma, M. (2009). Role of high-sensitivity C-reactive protein as a marker of inflammation in pre-dialysis patients of chronic renal failure. J. Indian Acad. Clin. Med., 10(1): 18–22.

Alghythan, A.K. & Alsaeed, A.H. (2012). Hematological changes before and after hemodialysis. Sci. Res. Essays, 7(4): 490–497. https://doi.org/10.5897/SRE11.1534.

Habib, A., Ahmad, R. & Rehman, S. (2017). Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters. Int. J. Res. Med. Sci., 5(11): 4998–5003. https://dx.doi.org/10.18203/2320-6012.ijrms20174959.

Han, Y.S. & Kishimoto, T. (1997). Reticulocyte maturity index reflects erythropoietin effects in hemodialysis patients. Osaka City Med. J., 43(1): 69–76.

Eschbach, J.W. (1989). The anemia of chronic renal failure: pathophysiology and the effects of recombinant erythropoietin. Kidney Int., 35(1): 134–148. https://doi.org/10.1038/ki.1989.18.

Jeng, M.R. & Glader, B. (2004). Acquired Nonimmune Hemolytic Disorders. In: Greer, J.P., Foerster, J., Lukens, J., Paraskevas, F., Rodgers, G.M. & Glader, B. (eds.), Wintrobe’s Clinical Hematology. 11th ed., Vol - 1, Chapter 38, Lippincott Williams & Wilkins, Philadelphia, pp. 1223–1246.

Means, R.T. (2004). Anemias Secondary to Chronic Disease and Systemic Disorders. In: Greer, J.P., Foerster, J., Lukens, J., Paraskevas, F., Rodgers, G.M. & Glader, B. (eds.), Wintrobe's Clinical Hematology. 11th edition, Vol - 1, Chapter 47, Lippincott Williams & Wilkins, Philadelphia. pp. 1445-1465.

Fishbane, S., Kalantar-Zadeh, K. & Nissenson, A.R. (2004). Serum ferritin in chronic kidney disease: reconsidering the upper limit for iron treatment. Semin. Dial., 17(5): 336–341. https://doi.org/10.1111/j.0894-0959.2004.17359.x.

Eschbach, J.W., Funk, D., Adamson, J., Kuhn, I., Scribner, B.H. & Finch, C.A. (1967). Erythropoiesis in patients with renal failure undergoing chronic dialysis. N. Engl. J. Med., 276(12): 653–658. https://doi.org/10.1056/NEJM196703232761202.

Gouva, C., Papavasiliou, E.C., Katopodis, K.P., Tambaki, A.P., Christidis, D. & Tselepis, A.D. (2006). Effect of erythropoietin on serum PAF-acetylhydrolase in patients with chronic renal failure. Nephrol. Dial. Transplant., 21(5): 1270-1277.

Wasti, A.Z., Iqbal, S., Fatima, N. & Haider, S. (2013). Hematological disturbances associated with chronic Kidney Disease and kidney transplant patients. Int. J. of Adv. Res., 1(10): 48-54.

Agarwal, R., Bills, J.E., Hecht, T.J. & Light, R.P. (2011). Role of home blood pressure monitoring in overcoming therapeutic inertia and improving hypertension control: a systematic review and meta-analysis. Hypertension, 57(1): 29–38. https://doi.org/10.1161/hypertensionaha.110.160911.


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Hassen, H. F., Al-Lami, M. Q. D., & Al-Saedi, A. J. H. (2018). Evaluation some Biochemical Levels in Patients undergoing Hemodialysis in Baghdad Governorate. Advances in BioScience, 9(2), 50–57. Retrieved from https://journals.sospublication.co.in/ab/article/view/247