Estimate the predictive value of POCUS in diagnosis of different causes of acute dyspnea in hemodialysis patients and compare between POCUS and CT in differentiation the causes of acute dyspnea in those population.

Dyspnea is "a subjective experience of breathing discomfort that consists of qualitatively dis-tinct sensations that vary in intensity.Dyspnea is a common symptom both in general practice and in hospital emergency rooms. It has been reported that 7.4% of patients presenting to emergency rooms complain of dyspnea;among patients in general practice, 10% complain of dyspnea when walking on flat ground and 25% complain of dyspnea on more intense exertion, e.g., climbing stairs.Dyspnea is considered acute when it develops over hours to days.Acute breathlessness in haemodialysis patients can be caused by various conditions such as acute coronary syndrome, catheter-related infection, pneumonia and pericardial effusion, as well as a reaction to the dialyser or medication given during dialysis Hence, clinical acumen remains integral in evaluation of acute breathlessness in this group of patients. Point of Care Ultrasound is complementary to a medical examination performed by primary care physicians in conjunction to physical examination to investigate unclear findings. As such it is used to find and identify either the presence or absence of specific pathological results seen in your patients.

Inclusion Criteria:

• All patients maintained on regular hemodialysis equal to / more than 6 months admitted to emergency department and ICU of Internal Medicine Department from September 2021 to August 2022 presented by acute dyspnea.

Exclusion Criteria:

• • Age less than 18

  • Diagnosed chronic pulmonary disease.
  • Severe heart failure (NYHA class IV).
  • Active malignancy.
  • Pregnancy.
  • Hepatic Failure (Child B,C).
  • Comatosed Patients.

- All patients maintained on regular hemodialysis equal to / more than 6 months admitted to emergency department and ICU of Internal Medicine Department from September 2021 to August 2022 presented by acute dyspnea.