The study aims to improve the health status of chronic renal failure patients on hemodialysis using nutritional education program on quality of life anserum d electrolytes level by application of physical and clinical evaluation and some biochemical analysis before and after a specified nutritional program

The function of kidney is to control many biological mechanism such as fluid , electrolyte

, PH balance , blood pressure , excretion of toxins and waste , vitamin D and hormonal synthesis . Chronic kidney disease is referred to as " The silent killer " because it often goes undiagnosed due to lack of apparent symptoms. Hemodialysis is life saving treatment in ESRD patients and prolongs life expectancy .

Hemodialysis is a process where the patient"s blood is passed through a dialysis venous catheter via a dialysis fluid solution in a hemodialysis machine to be filtered externally then returned to the patient . Hemodialysis therapy is usually associated with large number of morbidities . However, the inception of hemodialysis is linked with a decrease in functional status among elderly.

As many patients undergoing regular hemodialysis treatment suffer from protein-energy wasting which causes the patient to lose one-three kilos of lean body mass per year, losing body mass is associated with reduction of the overall well being and activity of the patient .

This is associated with worsening of the nutritional status and consequently increase hospitalization and mortality among those patients undergoing regular hemodialysis treatment . Many studies recommended to use both physical and nutritional therapy in order to enhance the outcome and experience of patients on hemodialysis .

The aim of the study:

The study aims to improve the health status of chronic renal failure patients on hemodialysis using nutritional education program on quality of life and serum electrolytes level by application of physical and clinical evaluation and some biochemical analysis before and after a specified nutritional program

Inclusion Criteria:

• hemodialysis patients whatever diabetic or hypertensive
• underweight patients

Exclusion Criteria:

• patients diagnosed CKD not on hemodialysis treatment
• patients with malignancy
• patients refuse to participate
• patients age over than 60 years or below 18
• patients with malignancy
• patients refuse to participate