Background: Optimal fluid therapy is considered as very crucial to decrease delayed graft function after renal transplantation. The intraoperative period of renal transplantation is divided into two phases. The first phase is the one prior to the reperfusion and the second is after reperfusion of the graft. Prior to reperfusion, physicians should not consider the patients as hypervolemic as they are usually adequately dialyzed. Frequency of haemodialysis and weight gain between haemodialysis and the amount of ultrafiltration during each session will decide the patients’ volume status. The patient is predisposed to be hypovolemic . Extravascular lung water (EVLW) is the amount of water that is contained in the lungs outside the pulmonary vasculature. It corresponds to the sum of interstitial, intracellular, alveolar, and lymphatic fluid, not including pleural effusions. Lung ultrasonography is accurate in detecting pulmonary edema and overcomes most limitations of traditional diagnostic modalities. Whether use of lung ultrasonography guided management has an effect on cumulative fluid balances and other clinical outcomes remains unclear.