Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background: Volume overload is a very important prognostic factor, associated with impaired oxygenation, end-organ damage, prolonged hospital stay morbidity and mortality in chronic kidney disease and end-stage renal disease (ESRD) patients.Controlling volume overload is one of the measures that successfully help to manage blood pressure (BP) without the use of anti-hypertensive medications in 90% of patients undergoing hemodialysis. Aim of work: To assess the role of N-terminal pro B-type natriuretic peptide (NT- pro BNP) and lung ultrasound in assessment of volume overload in patients on hemodialysis. Methods : 30 patients on regular hemodialysis for more than 3 months attending kasr Al-Ainy kidney center,Patients aged between 18 and 65 years with cardiac ejection fraction more than 50% , Our dialysis patients screened for those with difficult to control dry weight and blood pressure. We compare the changes in the serum N-terminal Pro-BNP and lung ultrasound before and after one month of increasing the ultrafiltration during the dialysis sessions and reaching new dry weight and their reflections on the blood pressure and other clinical tools of volume assessment. Results: The results showed significant decrease in plasma level of N.terminal pro-BNP after increasing ultrafiltration in our dialysis patients with significant P-value 0.002.There was a significant decrease in blood pressure (systolic and diastolic) and jugular venous pressure after one month of ultrafiltration (with P-value 0.001 ,0.001 ,0.002 respectively). The results showed also significant decrease in number of B lines using lung ultrasound after we increased the ultrafiltration (with significant P-value 0.001

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