Abstract
Case Summary: Olfat Mahmoud Magdy is 66 years old female resident from Benghazi, Libya was a known case of Diabetes Mellitus with End Stage Renal Disease (ESRD) on Dependant Haemodialysis. The whole Episodes were noticed after her last child birth at the age of 41 years with the detection of Diabetes and later landed into Renal Failure. She was some of the survival patients in such a prolong period of maintenance Haemodialysis.

The sequence of her disease is with a fluctuating renal profile parameters and repeated anemia and infection of hepatitis B and hepatitis C during the course of disease and later seroconversion takes placed. She is non-reactive now when last detected six months ago. She is carried with Maintenance Haemodialysis three times a week and has an uneventful life.

She had repeated hospitalization due to rising renal profile of Serum Creatinine, Serum Potassium and ECG changes with associated symptoms of breathlessness and chest pain. Quite often she was required to admit with this problem in Emergency and managed with Emergency Haemodialysis.

On the line of further management she was re-investigated including blood, color echo cardiography, Immunoserolgy and MRI, the parameters are suitable for renal transplant, however due to non-availability of donor, Maintenance Haemodialysis is continuing. The final clinical Impression is LVH (Left Ventricular Hypertrophy) with DC (Dilated Cardiomyopathy) with CRD (Chronic Renal diseases) & ESRD (End Stage Renal Disease) with Diabetes and Hypertension.