الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
ESRD is a condition of great public health concern. RRT is crucial for survival. HD is the most common RRT modality all over the world. In oliguric and anuric patient excess fluid will be removed by UF.
Patients on maintenance HD suffer from numerous diseases and complications that have been associated with higher morbidity and mortality. The most prevalent morbidities are CVD, hypertension, and volume overload. Volume overload as result of IDWG in which between two successive HD sessions, salt and water build up, and since HD sessions are brief and sporadic, the surplus volume will not be sufficiently cleared. Therefore, volume overload will result in cardiomyocyte damage and maladaptive alterations, which in turn promote eccentric hypertrophy and left ventricular dilatation. These modifications and unfavorable changes eventually lead to heart failure.
Early identification of volume overload is essential, whether clinically or through techniques that identify latent pulmonary congestion before the onset of signs and symptoms, to give the opportunity for early management and avoid significant volume overload consequences.
Blood pressure and regular clinical examinations might not properly detect volume overload especially in subclinical context. Therefore, methods for evaluating dry weight are continually advancing, with numerous techniques having been developed, including laboratory biochemical markers, IVC measurement, chest radiography, LUS, BVM, and BIS, as well as advanced analytical management like machine learning technology.
The objective of this investigation was to evaluate the dry weight of ESRD patients using ePAWP, evaluate the effect of increasing UF on ePAWP value, and to demonstrate the effect of ePAWP-guided UF on various echocardiographic parameters, blood pressure measurement and functional capacity as evaluated by 6-MWT.
The study was conducted on 60 ESRD patients on HD for more than 6 months, patients were divided according to the post-dialysis ePAWP value obtained by TDI into group A (30 patients) with post-dialysis ePAWP <12 mmHg and group B (30 patients) with post-dialysis ePAWP >12 mmHg. group B underwent additional stratification, giving rise to two distinct subcategories, group B1 (14 patients) subjected to ePAWP guided-UF and group B2 (16 patients) maintained on their conventional HD. Both sub-groups were followed for 3 months