Critically ill patients with acute renal failure who receiving the dialysis therapy were suffered from many complication: dialysate during hemodialysis session. Aim: this study was carried out to investigate the effect of nursing guidelines for Complications of acetate and bicarbonate Solutions during hemodialysis among acute renal failure patients, Assuit University Hospital. Design: Quasi experimental design. Setting: This study was carried out at hemodialysis unit, ICUs Assuit University Hospital. Subjects: Sixty adult male and female critically ill patients with acute renal failure who are admitted to hemodialysis unit. Tools: Two tools were developed by the researcher and used in this study which are; tool I: Personal and medical data sheet and hemodialysis, tool II: Hemodialysis complications assessment sheet. Methods: Interview, observation and reviewing patient`s records where utilized to collect data pertinent to the study. Each patient was monitored closely and give nursing care for ten minutes before connection, during the dialysis session and ten minutes after disconnection from dialysis machine three times per week for two successive weeks. Results: The acetate groups had experienced many complications rather than bicarbonate. There was a significant statistical difference between both groups with (p value=0.001). The complications developed where, hypotension, chest pain, dysrhythmia, muscle cramps, nausea, vomiting, headache, pruritus. Conclusion: Nursing care reduces complications for both groups acetate and bicarbonate dialysis documented lesser complications in bicarbonate than acetate group. Recommendation: Replication of this research on a larger probability sample acquired from different geographical areas in the Arab republic of Egypt. [Naglaa Elrashedy, Warda Mohammed, Mona Mohammed, Mervat Abdel-Aziz and Maher Abd El Naser. Effect of Nursing guidelines to reduce Complications of Acetate and Bicarbonate Solutions during Hemodialysis among Acute Renal Failure Patients, Assuit University Hospital.