الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study was carried out on 15 patients on maintenance hemodialysis, randomly selected from the dialysis unit of Mansoura Urology and Nephrology Center. Among them 3 were females and 12 were males aged 24-67 years. The study was divided into two phases, at the start of the study the patients were assessed by thorough clinical and laboratory investigations and their dialysis was assessed by urea kinetic modeling utilizing nomographic approach. Their autonomic functions were assessed by clinical examination, handgrip and sympathetic skin response test. Dialysis dose was reviewed to achieve a target of KUv of 1.3, nutrition also assessed by nPCR which was achieved to the target level. The duration of the study was 3 months, during this period targeted Kt/v and nPeR were maintained. At the end of the study all patients were assessed by the same way. Our results showed that increasing dialysis dose in terms of Kt/v and patients nutrition in terms nPCR had beneficial effect on autonomic nervous system as assessed by sympathetic skin response test, also there was improvement in patient’s quality of life. Conclusion 1. From this work, it becames clear that the term, dialysis adequacy is crucial and should be achieved. However, it is not an easy task and any failure to achieve this goal is attributed to both human and technical errors. This can be overcome by prescribing possibly excessive amounts of dialysis. Determination of that amount, however, is difficult and controversial. The only clear solution is paying meticulous attention to factors affecting dialysis delivery and measuring the outcome of treatment based on urea kinetic modeling.