SUMMARY AND CONCLUSIONAdrenomedullin (ADM), consisting of 52 amino acids, is a recent multifunctional regulatory peptide discovered by Kitamura et al. (1993). ADM is synthesized by the adrenal medulla, ventricle, kidney, central nervous system, endothelial and vascular smooth muscle cells.Furthermore, in human and rat uterus, ADM is mainly located in the endometrium suggesting that ADM may act on the myometrium in a paracrine manner. Both ADM and its receptors are expressed in the uterus and their expression markedly increased during pregnancy. The physiological meaning of increased adrenomedullin production observed in pregnancy is still to be established. Hence, it was decided to examine the modulative capability of ADM on the contractile response of pregnant rat uterus.Therefore, this work was carried out on 32 healthy adult albino rats (30 female rats and 2 male rats for induction of pregnancy). Adult female rats were subdivided into three equal groups (each 10 rats).Group I : non-pregnant rats.Group  : early pregnant rats at day 4.Group  : late pregnant rats at day 19.The first day of pregnancy was determined by examination of vaginal smear of females the next morning after mating with a male. The presence of sperms indicated the first day of gestation.Moreover, the contractile response of uterine strips isolated form non pregnant, early and late pregnant rat uterus was studied in vitro in presence and absence of ADM by a variety of uterotonic agents as follow:* Group I: consisting of 10 rats; from each non pregnant rat uterus, four isolated muscle strips were taken. Each strip was used only in one experiment, so the first group was subdivided into four subgroups as follow:Subgroup 1: to study the effect of ADM and ADM22-52 (ADM receptor antagonist) on spontaneous myometrial contraction.Subgroup 2: to study the effect of ADM on periodic myometrial contraction induced by bradykinin (BK) and the effect of ADM and ADM22-52 (ADM receptor antagonist) on periodic myometrial contraction induced by bradykinin (BK).Subgroup 3: to study the effect of ADM on periodic myometrial contraction induced by oxytocin (OT).Subgroup 4: to study the effect of ADM on periodic myometrial contraction induced by prostaglandin F (PG F2 ).* Group II, III: the same was done as in Group I.Furthermore, the rats were sacrificed and blood was collected then the serum was separated. The levels of estrogen, and progesterone were estimated in all studied groups to determine the effect of steroid hormones on uterine responsiveness to ADM.The results of the present study revealed that:** ADM significantly inhibited spontaneous and bradykinin (BK)- induced periodic myometrial contractility. However, ADM had no effect on oxytocin (OT)- and PGF2- induced periodic myometrial contractility in non-pregnant group, early pregnant (day 4) group and late pregnant (day 19) group.** ADM receptor antagonist (ADM 22-52) was found to block the effect of ADM on frequency, amplitude and basal tone of spontaneous myometrial contractility in non pregnant group, early pregnant (day 4) group and late pregnant (day 19) group. Therefore, this study proved that specific ADM receptors were found to be present in the uterus mediating the inhibitory effect of ADM.From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.esia was established, a continuous epidural infusion was started with:-Group la receiving bupivacaine 0.12S% plus fentanyl SOug(1ug/ml);Group Ha receiving lidocaine O.S% plus fentanyISOug(lug/ml) and;Group Ib receiving bupivacaine 0.12S% plus fentanyl SOug (l ug/ml)plus morphine 2mg (40ug/m/