Background: The incidence of intradialytic hypotension (IDH) is approximately 10-12% of treatments. Recurrent interruption of blood flow to vital organs in individuals with IDH may adversely affect the cardiovascular, central neurological, renal, and gastrointestinal systems^[1].  Aim of the work : To investigate the ability to predict  hemodynamic intolerance to fluid removal by respiratory variations in IVC diameter and PLR test before intermittent renal replacement therapy.to Methods: This prospective cohort observational work was carried out on 40 individuals aged 18 years old or more, both sexes, with clinical criteria of acute kidney disease and sinus rhythm. Participants were categorized into two groups: group I:patients who didn't develop IDH, and group II: patient who developed IDH.  Results: The IVC collapsibility and change in COP (cardiac output) were significantly greater in Group II (16 patients) contrasted to Group I (24 patients). The ROC curve of predicted probability [COP response (>12.0%) and IVC collapsibility response (>50.0%)] is associated with intradialytic hypotension 0.775 (95% CI 0.624-0.926, P =0.004). Conclusions: COP response (>12.0%) and IVC collapsibility response (>50.0%) had a good predictive value of IDH.