الفهرس 
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Abstract
Patients with ESRD undergoing hemodialysis are at greater risk
of cardiovascular disease–related morbidity compared with the
general population, with published estimates suggesting that the
differential risk is as high as 8- to 20-fold.
One compelling and potentially modifiable putative CV risk
factor is ultrafiltration rate, as native kidney function wanes,
ultrafiltration is necessary to maintain volume control (i.e., salt and
water balance), but it simultaneously and disadvantageously promotes
non-physiological fluid shifts and hemodynamic instability.
The aim of this study is to find out the relationship between
repeated excessive fluid removal during haemodialysis and
cardiovascular morbidity in patients with IDWG.
This study was conducted on one hundred and twenty ESRD
patients, from hemodialysis unit at El-sahl Teaching Hospital CairoEgypt
during the period from June 2016 to October 2017.
The following patients were excluded from the study:
Patients on HD for < 6 months.
Recent infection.
Patients under immunosuppressive treatment.
Malignancy.
Pregnant or lactating women.
Lack of ability to comply with the protocol of the study.
All participants were thoroughly interrogated and examined
clinically and were subjected to HB, serum albumin, serum calcium,
serum Phosphorus, serum Na, serum K, pre and post dialysis BUN,
serum creatinine, iPTH, total cholesterol and triglyceride,
echocardiography examination pre and post dialysis (within 0-30
minutes after dialysis) to evaluate global and regional systolic
function.
According to the presence or absence of IDWG, patients were
classified into 2 main groups:
group (Ӏ): patients with IDWG.
group (ӀӀ): patient without IDWG.
Further sub calcification of G Ӏ patients according to fluid removal
rate (UFR) were made into 2 subgroups:
Subgroup ӀA : patients with UFR ≤ 10 ml/h/kg B.W
Subgroup ӀB : patients with UFR > 10 ml/h/kg B.W
Results of the study demonstrated that residual renal function was
significantly lower in patients with IDWG compared to patients
without IDWG, while dialysis vintage, SP KT/v, pre dialysis systolic
BP and frequency of intradialytic hypotension were significantly
higher in those patients.
Higher ultrafiltration rate group are associated with higher
frequency of hypertension, stroke and intradialytic hypotension
compared to lower ultrafiltration rate group.