Abstract
A 7-year-old boy had undergone renal transplantation at the age of 2years and 2months. However, because of infection and thrombotic microangiopathy due to Tacrolimus hydrate the kidney was removed soon after the transplantation and hemodialysis was started. After the initiation of hemodialysis he had no cardiomegaly and no hypotension for 4years and echocardiography revealed that left ventricular diastolic dimension was 101% of normal value. On the process of fitting his dry weight to his growth, cardiothoracic ratio developed to 57% during the last one year. Therefore, his dry weight was decided to be decreased. But cardiothoracic ratio did not remarkable change and he became hypotensive. Echocardiography showed normal left ventricular systolic function, contractility and cardiac output. However, left ventricular diastolic dimension was decreased to 91% of normal value and suggested that the hypotension was due to decreased preload. So his dry weight was increased. As a result left ventricular diastolic dimension was increased to 98% of normal value, and hypotension was disappeared. And no cardiomegaly was shown on the chest rentogenogram. Assessing of left ventricular preload was difficult only using chest rentogenogram. Echocardiographic study was effective on the decision of dry weight.
