Anesthetic management for nephrectomy using HemoSonic 100, was performed in a patient with chronic renal failure and dilated cardiomyopathy (DCM). Anesthesia was induced and maintained with infusion of propofol and ketamine, and intermittent administration of fentanyl. During the surgery left ventricular ejection time (LVETc) decreased due to active bleeding from the renal artery. LVETc provided useful information for adequate preload and rate of transfusion in this case. Anesthesia and operation were finished successfully with relatively stable circulatory condition. We conclude that HemoSonic 100 is a useful monitor in anesthetic management of a patient with DCM, especially for the assessment of adequate preload.